腹腔镜手术和药物治疗异位妊娠的疗效比较

Comparison of the therapeutic efficacy between the conservative medical treatment and laparoscopic surgery on ectopic pregnancy

目的:观察并比较对异位妊娠患者采用腹腔镜手术和药物保守治疗的疗效。方法:以2010年1月至2016年6月收治的异位妊娠患者224例为研究对象,随机分为观察组和对照组,各112例,观察组患者采用腹腔镜下输卵管妊娠开窗病灶清除术治疗,对照组患者给予药物保守治疗,观察两组患者治疗效果。结果:观察组患者住院时间短于对照组(t=9.853,P=0.002),观察组患者血清人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)恢复正常时间短于对照组(t=8.639,P=0.012);观察组患者输卵管通畅率高于对照组(χ2=5.972,P=0.026);两组患者术后再次异位妊娠发生率比较,差异无统计学意义(P>0.05)。结论:相对于药物保守治疗,采用腹腔镜下输卵管妊娠开窗病灶清除术治疗异位妊娠,能有效提高输卵管的通畅度,缩短治疗时间,可在临床推广使用。

Objective：To observe and compare the therapeutic efficacy between the conservative medical treatment and laparoseopic surgery on ectopic pregnancy. Methods：224 patients with ectopic pregnancy hospitalized from January 2010 to June 2016 were randomly divided into the ob- servation group and the control group, 112 patients in each group. The observation group was treated with laparoscopic debridement of tubal preg- nancy while the control group was treated with the conservative medical treatment, with the therapeutic efficacy observed. Results：The hospitaliza- tion time in the observation group was shorter than that in the control group （ t = 9. 853, P =0. 002 ） ;the HCG recovery time in the observation group was also shorter than that in the control group（ t = 8. 639, P = 0. 012 ） ; the patency rate of fallopian tubes in the observation group was significantly higher than that in the control group（ X2 = 5. 972, P = 0. 026 ）. There was no significant difference in postoperative ectopic pregnancy rate between the two groups （ P 〉0. 05 ）. Conclusion：Compared with conservative medical treatment, laparoscopic debridement of tubal pregnan- cy can effectively enhance the fallopian tube patency in patients with ectopic pregnancy and shorten recovery time, which can be popularized in the clinical practice.