腹腔镜手术治疗妊娠期妇科疾病的临床分析

目的探讨腹腔镜手术在妊娠期妇科疾病中的应用和特征研究。方法分析因妇科疾病行腹腔镜治疗的35例妊娠期妇女的临床资料,孕周在11周以内者21例,11周以上者14例,最大孕周22周。其中宫内妊娠合并宫外孕5例,均为输卵管不通而行体外受精胚胎移植术后（IVF.ET）受孕,其中输卵管妊娠破裂者6例,因B超提示附件包块而入院;妊娠合并卵巢囊肿蒂扭转9例;合并黄体破裂8例;合并卵巢巧克力囊肿破裂7例;妊娠期子宫浆膜层血管自发破裂3例。术前B超提示有附件包块23例;后穹窿穿刺或腹腔穿刺抽出不凝血8例,其中4例患者出现面色苍白、血压下降等休克表现。结果其中15例行急诊手术,14例行择期手术,手术全部采用腹腔镜,而且全部成功,无一例发生手术和麻醉并发症。24例已足月妊娠分娩,新生儿无畸形,9例仍在妊娠中晚期随诊中,1例因其它因素行人工流产术,1例术后2周因胚胎停止发育行清宫术。结论腹腔镜手术治疗妊娠期妇科疾病是安全和可行的。

Gynecological Laparoscopic Surgery Clinical Analysis of Pregnancy

Objective laparoscopic surgery in gynecological diseases of pregnancy and characteristics.Methods For treatment of gynecological diseases,35 cases of laparoscopic clinical data of pregnant women,gestational age 11 weeks or less in 21 cases,14 cases more than 11 weeks,maximum 22 weeks of gestation.Intrauterine pregnancy with ectopic pregnancy in which 5 cases were fallopian tube obstruction and after in vitro fertilization and embryo transfer （IVF.ET）pregnancy,which ruptured tubal pregnancy in 6 patients,B-Tip adnexal masses because of hospitalization;pregnancy with ovarian cyst9 cases of torsion;combined luteal rupture in 8 cases;with ovarian chocolate cyst rupture in 7 cases;pregnant uterine serosa 3 cases of spontaneous rupture of blood vessels.Preoperative B-23 cases suggestive of adnexal masses;posterior fornix puncture puncture or intraperitoneal blood was withdrawn in 8 cases,4 patients had pale,blood pressure,shock and other manifestations.Results Of which 15 cases of emergency surgery,14 routine elective surgery,laparoscopic surgery all use,and all the success,and no case of surgery and anesthesia complications.24 patients had fullterm pregnancy childbirth,newborns without malformations,9 patients were still followed up in late pregnancy,1 case because of other factors,artificial abortion,one case of embryos 2 weeks after cessation of growth due to curettage.Conclusion Gynecological laparoscopic surgery during pregnancy is safe and feasible.