输卵管妊娠腹腔镜手术70例临床分析

目的观察腹腔镜两种手术方式治疗输卵管妊娠的围手术及再次妊娠情况。方法对滁州市第二人民医院2004年4月-2008年12月期间收治的输卵管妊娠患者行腹腔镜手术治疗,其中Ⅰ组：保守性手术28例;Ⅱ组：输卵管切除术42例。比较两组手术时间、出血量、手术结局、术后再次妊娠情况。结果Ⅰ组手术时间、出血量均高于Ⅱ组,差异有统计学意义（P〈0.05）;持续性异位妊娠Ⅰ组高于Ⅱ组;再次宫内妊娠及异位妊娠,Ⅰ组高于Ⅱ组,差异无统计学意义（P〉0.05）。结论腹腔镜保守性手术难度、术后持续性异位妊娠及再次妊娠率均高于输卵管切除术,但再次妊娠与对侧输卵管及盆腔病变情况有关,在对侧输卵管正常,而患侧输卵管病变严重的情况下则行患侧输卵管切除术。

Clinical Analysis of 70 Patients with Tubal Pregnancy Undergoing Laparoscopic Surgery

Objective To investigate the effects of laparoscopic salpingostomy and salpingectomy on the tubal pregnancy,and evaluate the outcome of the subsequent pregnancy.Methods The clinical data of 70 patients with tubal pregnancy undergoing laparoscopic surgery from April 2004 to December 2008 were analyzed retrospectively.28 patients in the group Ⅰ received the laparoscopic salpingostomy,and 42 patients in the group Ⅱ received the laparoscopic salpingectomy.The operative time,bleeding volume,outcomes of surgery and subsequent pregnancy were compared between the two groups.Results The operative time and bleeding volume in group Ⅰ were higher than those in group Ⅱ（P0.05）;The incidence of persistent ectopic pregnancy in group Ⅰ was higher than that in group Ⅱ;The incidence of the subsequent pregnancy and ectopic pregnancy in the group Ⅰ was higher than that in the group Ⅱ,but it was not statistical significant P0.05）.Conclusion The degree of difficulty,incidence of subsequent pregnancy and ectopic pregnancy in the laparoscopic salpingostomy group were higher than that in the laparoscopic salpingectomy.The incidence of subsequent pregnancy depends on the status of contralateral tube.When the contralateral fallopian tube is normal,the laparoscopic salpingectomy should be performed for the severe injured tube.