腹腔镜下保守性手术治疗输卵管妊娠的临床研究

Clinic research of conservative operation treating tubal pregnancy by laparoscope

目的 探讨腹腔镜下保守性手术治疗输卵管妊娠的手术适应症 ,手术方式 ,疗效及预后。 方法 对有生育要求的确诊为未破裂型输卵管妊娠 ,包块直径<5cm患者30例 ,在腹腔镜下行输卵管切开术及输卵管胚胎吸除术 ,并与同期剖腹行输卵管妊娠保守性手术20例作对比研究。 结果 腹腔镜组手术成功率为93% ,与剖腹组相似 (p>0.05) ,腹腔镜组术后输卵管复通率93.6% ,宫内妊娠率43.3% ,显著高于剖腹组的64.3%及20% (P<0.05)。结论 腹腔镜下保守性手术治疗输卵管妊娠疗效满意 ,术后宫内妊娠机率优于剖腹组 ,此术式是未育患者的较佳选择。

Objective To explore the operation adaptations,method,effect and prognosis of conservative operation treating tubal pregnancy by laparoscope. Methods 30patients who had birth demand and were diagnosed nonrupture type tubal pregnancy and mass diameters were less than5cmwere selected to performed salpingotomy and embryo sucking operation by laparoscope,and compared to20patients who were cut the belly open and performed conservative operation treating tubal pregnancy synchronously. Results The operation success rates were similar in laparoscope group as compared to those of cutting the belly open group(P>0.05).The rates of fallopian tube recanalization were93.6%and the rates of Intrauterine pregnancy were43.3%in laparoscope group,which all were significant higher than those of cutting the belly open group(64.3%and20%respectively)(P<0.05). Conclusion Conservative operation treating tubal pregnancy by laparoscope could get satisfactory effect and postoperative Intrauterine pregnancy rates were better than those of cutting the belly open group.The operation could be made as the first selection in nonbirth patients.