腹腔镜下保守性手术治疗输卵管间质部妊娠

目的评价腹腔镜下保守性手术治疗输卵管间质部妊娠的可行性和价值。方法采用电视腹腔镜对13例未破裂型输卵管间质部妊娠进行间质部切开取胎缝合术,并与10例剖腹的输卵管间质部妊娠切开缝合术比较手术情况。结果两组无一例切口感染。两组在住院时间、血HCG下降时间相似(P>0.05),术中出血量、手术时间、术后胃肠功能恢复、术后病率方面,腹腔镜组均优于剖腹组(P<0.01)。结论腹腔镜下卵管间质部切开缝合治疗间质部妊娠安全、可靠、创伤小、并发症少,可保留患侧卵巢的血供和内分泌功能,特别是对未生育要求保留卵管者是一种较好但要求较高的镜下缝合技术。

Conservative Operation under Laparascope in the Treatment of Interstitial Tubal Pregnancy

Objective To evaluate the feasibility and clinical value of conservative operation under laparascope in the treatment of interstitial tubal pregnancy. Methods 13 cases of nonrupture interstitial tubal pregnancy received interstitial portion incision for embryo-taking under laparoscope (laparoscope group), and the operative situation were compared with 10 cases of interstitial tubal pregnancy with abdominal incision sutura (abdominal group). Results No incision infection was found in two groups. The differences of hospitalization time, blood HCG reduction time between two groups were not statistically significant (P >0.05); while the laparoscope group was superior to the abdominal group in intraoperative blood loss, operative time, postoperative gastrointestinal function recovery, postoperative morbidity (P <0.05). Conclusions Interstitial portion incision for embryo-taking under laparoscope in the treatment of interstitial tubal pregnancy has the advantages of safety, reliablity, small trauma, fewer complications and retaining the ovarian blood supplyand endocrine function, which is a better but higher demanding endoscopic suturing technique for nonparous patients with the requirement of retaining oviduct.