输卵管妊娠的腹腔镜下保守性手术

目的　探讨输卵管妊娠在腹腔镜下保留输卵管的手术治疗效果。方法　应用腹腔镜对 2 8例输卵管妊娠病人 ,采用从输卵管妊娠部位开窗或输卵管破口处取胚 ,系膜下注射氨甲喋呤 (MTX)。结果　 2 8例输卵管妊娠流产型、破裂型、未破裂型等全部完成保留输卵管手术 ,血HCG术后 2周降至正常。其中 3例发生持续性妊娠 ,肌注MTX后痊愈。术后 2 0例行HSG或输卵管通水术 ,通畅 16例 ,术后再次宫内妊娠 6例。结论　腹腔镜保守性手术治疗输卵管妊娠可以保留输卵管及生育功能。

Conservative operation for the patients with tubal pregnancy under laparoscopy

Objective To investigate therapeutic effect of conservative operation with laparoscopy for patients with tubal pregnancy. Methods 28 patients with tubal pregnancy were performed with the conservative surgery: fenestrating on the position of tubal pregnancy or taking out embryos from the tubal crevice combined with injection of MTX under laparoscopy. Results All of the 28 patients’ tubes were retained successfully. Blood HCG recovered to normal levels two weeks after operation. Only three patients kept pregnant and completely recovered after intramuscular injection of MTX. 20 patients were carried out HSG after operations, among whom the tubes of 16 patients were patent, 6 patients were interuterine pregnant. Conclusion Conservative treatment for the patients with tubal pregnancy under laparoscopy is a suitable method for retaining the fertile tubes.