腹腔镜在中西医结合治疗宫外孕中的应用

The Role of Laparoscopy in the Non-Operative Treatment of Ectopic Pregnancy by TCM-WM

中西医结合非手术治疗宫外孕84例,腹腔镜直视下观察异位妊娠部位、病变发展阶段,治疗均告成功。治疗后腹腔镜随访20例,亚急性期的输卵管通畅率比包块形成期高,腹腔镜对宫外孕早期诊断、鉴别诊断、中西医结合治疗及随访极为重要,也有助于病因、预后及本病进一步探讨。

From 1980～1983,of 202 cases of suspected ectopic pregnancy examined by laparoscopy,133 proved to be early ectopic with or without hematomas.Laparoscopy clearly showed the site of ectopic pregnancy as well as the stage of development of the disease which helped much in the clinical staging and planning of the treatment tegime. All the cases that received the treatment were cured. Twenty cases were given a follow-up examination 3 or more months after treatment.It was found that sub-acute cases of bleeding gave better results than those with hematocele—the majority of the cases showing normal pelvic findings with patent tubes belonged to the subacute cases,while all the hydrosalpinxs found resulted from the cases with hematoma formation(P<0.01). Mild or filmy adhesions were separated during the laparoscopic procedure.Pregnancy followed in quite a few cases.The results showed that early diagnosis and prompt adequate treatment gave the bestiesults.It was concluded that in a conservative treatment of ectopic pregnancy using TCM-WM,laparoscopy played a very important role:it enabled the attending gynecologist to establish the diagnosis at a very early stage of the disease,provided clear and concise documentation,helped proper treatment and protocol planning and thus gave very good prognoses to complication of pregnancy,which is sometimes very dangerous. For those who require tuboplasty,laparoscopic assessment prior to surgery is essential.With the accumulation of more cases it is hoped that laparoscopy will also help to clarify the etiological factors of extra-uterine pregnancy.