腹腔镜与开腹保守手术治疗异位妊娠对比分析

目的:探讨腹腔镜保守性手术对有生育要求的异位妊娠患者的疗效及再次妊娠的影响。方法:回顾分析264例行保守性手术治疗的有生育要求的异位妊娠患者,其中通过腹腔镜手术136例,开腹手术128例。比较两组手术时间、术后输卵管通畅率、再次妊娠率。结果:腹腔镜组平均手术时间(45·47±17·24)min,开腹组平均手术时间(67·70±15·36)min(P<0·05)。腹腔镜组术后保留输卵管通畅率94·1%,受孕率71·3%,开腹组术后保留输卵管通畅率80·5%,受孕率66·4%(P>0·05)。腹腔镜组与开腹手术组比较手术时间短、恢复快,术后输卵管通畅率与再次妊娠率无显著差异。结论:腹腔镜手术更适用于年轻、有生育要求患者。

Laparoscopy Versus Laparotomy for Conservative Surgical Management of Ectopic Pregnancy

Objective:To compare the surgical managements for patients with ectopic pregnancy and their effect on fertility outcome.Methods:264 ectopic pregnancies received conservative surgery to preserve fertility were analyzed.Laparoscopy was performed in 136 cases, laparotomy in 128 cases.Operative findings and surgical data were collected.Restoration of oviduct and subsequent fertility are followed up.Results:The average operation time for laparoscopie is (4 547±1 724)min; while the average operation time for surgery is (677± 1 536)min (P<0.05).After laparoscopie, the rate for fallopian tube clearance is 94.1% and for pregnance is 71.3%; after surgery, the rate is 80.5% and 66.4% respectively.No serious complications occurred. The operation time and length of hospitalization for laparoscopic conservative surgery were shorter than those for laparotomy.Less disability was seen in those for laparoscopy.No significant difference was found in restoration of oviduct and subsequent fertility.Conclusion:Laparoscopic surgery has advantages over open surgery in the treatment of ectopic pregnancy for preservation future reproductive potential of the affected patients.