腹腔镜下诊治异位妊娠288例分析

目的:回顾性分析腹腔镜在异位妊娠诊治中的作用。方法:选择2005年1月~2006年12月南京市妇幼保健院腹腔镜下诊断治疗的异位妊娠患者288例。腹腔镜下输卵管切除术182例,输卵管保守性手术97例,腹腔镜下卵巢妊娠物清除加部分卵巢切除术7例。结果:288例均在腹腔镜下明确诊断,286例在镜下完成手术。发生持续性异位妊娠4例。监测输卵管切除术后血β-HCG转为正常时间为(8±2)天,月经复潮时间为(32±4)天;输卵管保守治疗者血β-HCG转为正常时间为(16±3)天,月经复潮时间为(45±6)天。106例保守治疗者随访2~4个月,子宫输卵管碘油造影提示镜下手术侧输卵管通畅率为70.3%。结论:腹腔镜是诊治异位妊娠安全有效的方法。

Clinical analysis of laparoscopic operations for 288 entopic pregnancy patients

Objective:To retrospectively analyze the efficacy of laparoscopic operations in the checkup and treatment of ectopic pregnancy.Methods:A total of 288 cases of ectopic pregnancy in Nanjing Maternal & Child Health Hospital from January 2005 to December 2006 were studied.Laparoscopic operations included 182 cases of salpingectomy,97 cases of oviduct-sparing operation,and 7 cases of lesion clearance from ovary.Results:The diagnosis were laparoscopically completed in all the 288 cases,and 286 of 288 were operated laparoscopically.Persistent ectopic pregnancy occurred in 4 cases.Postoperative monitoring of serum β-hCG levels showed the recovery time to normal levels after the treatment salpingectomy was(8±2)days,and(16±3)days after lesion clearance.Regular menstruation resumed at(32±4)days after salpingectomy and at(45±6)days after lesion clearance.Follow-up checkups with uterotubography in 97 cases for 2~4 months found a patent rate of the operated oviduct at 70.3%.Conclusion:Laparoxcopic operations is a safe and effective option in the diagnosis and treatment of ectopic pregnancy.