腹腔镜输卵管开窗剥除法治疗输卵管妊娠40例分析

Analysis of 40 cases of tubal pregnancy treated by laparoscopic tubal fenestration and embryo removal

目的探讨腹腔镜输卵管开窗剥除法治疗输卵管妊娠的可行性和临床疗效。方法回顾性分析2019年5月至2020年10月武汉市第一医院妇科因输卵管妊娠行腹腔镜输卵管开窗剥除法治疗的40例患者的临床资料,分析该术式的安全性和有效性。结果40例患者中无1例中转开腹手术。手术时间10~30min,平均(16.6±0.5)min;术中出血量0~10mL,平均(2.4±0.2)mL;术后肠道功能恢复时间3~10h,平均(5.3±0.2)h;术后住院时间1~5d,平均(2.5±0.5)d,术后无1例出现持续性异位妊娠,术后3个月经周期后行子宫输卵管造影检查输卵管通畅性,40例患者手术侧输卵管均通畅。结论腹腔镜输卵管开窗剥除法在输卵管妊娠的治疗中可保护患者生育功能,术后无持续性异位妊娠发生,安全有效,适用于年轻有生育需求女性。

Objective To study the feasibility and clinical effect of laparoscopic tubal fenestration and embryo removal in the treatment of tubal pregnancy.Methods A total of 40 cases of patients with tubal pregnancy treated by laparoscopic feneoriectomy and embryo removal were selected from Department of Gynecology of Wuhan No.1 Hospital from May 2019 to October 2020.Analyzed the safety and effectiveness of the operation.Results None of the 40 patients was converted to open surgery.The operation time was 10~30 min, and the mean time was(16.6±0.5) min.The intraoperative blood loss was 0~10 mL,with an average of(2.4±0.2) mL.The postoperative recovery time of intestinal function was 3~10 h,(5.3±0.2) h on average;The postoperative hospital stay was 1~5 days, with an average of(2.5±0.5) d.No persistent ectopic pregnancy occurred in any patient after the operation.Hysterosalpingography was performed 3 menstrual cycles after the operation to check the fallopian tube patency, and 40 patients’ fallopian tubes were patency.Conclusion Laparoscopic fenestration of tubal pregnancy is a new method for embryo removal by fenestration of tubal pregnancy, which can protect the patient’s reproductive function in the treatment of tubal pregnancy without persistent ectopic pregnancy, safe and effective, and suitable for young women with childbearing needs.