腹腔镜输卵管妊娠保守手术改良方案的临床研究

目的探讨腹腔镜输卵管妊娠保守手术改良方案的优点和临床意义。方法选择2012年1月至2013年6月肇庆市端州区妇幼保健院收治的输卵管妊娠行腹腔镜保守手术治疗的患者60例,其中36例采用改良方案为研究组,24例采用传统的保守手术为对照组。对两组术中出血量等指标进行分析。结果两组术中出血量、手术时间、持续性异位妊娠率有显著性差异(P<0.05)。两组患者术前β-人绒毛膜促性腺激素(human chorionic gonado-trophin,HCG)水平比较差异无统计学意义(P>0.05),术后第1天和第3天血β-HCG下降率及其降至正常水平的时间比较差异均有统计学意义(P<0.05)。两组术后患侧输卵管通畅度比较差异无统计学意义(P>0.05)。研究组患者患侧和对侧卵巢动脉收缩期最大血流速度、舒张末期最小血流速度,阻力指数的差异比较均无统计学意义(P>0.05)。结论腹腔镜输卵管妊娠保守手术改良方案优于传统的保守手术,可为术后输卵管功能的恢复提供新的依据和参考。

Clinical study of modified protocol in laparoscopic conservative surgery for tubal pregnancy

Objective To research clinical advantages and the significance of modified protocol of laparoscopic conservative surgery for tubal pregnancy. Methods Among 60 patients with tubal pregnancy in Duanzhou District Maternal and Child Health Hospital in Zhaoqing City from January 2012 to June 2013, 36 cases were taken modified protocol of laparoscopic conservative surgery as study group and the other 24 cases were taken usual conservative surgery as control group. The data about the volume of hemorrhage during the operation and other indicators was analyzed between two groups. Results The differences about the volume of hemorrhage during the operation, operative time and the rate of persistent ectopic pregnancy were significant between two groups（P 〈0. 05）. The level of β -human chorionie gonadotrophin（HCG） before the surgery showed no significant difference between two groups （ P 〉 0. 05 ）. The decline rate of serum β - HCG levels on the first day and the third day post - operation and the recovery time to normal level were significantly different （ P 〈 0. 05 ）. No significant difference was found in post - operative tubal patent rate between two groups（ P 〉 0. 05 ）. The differences about the maximum velocity about systolicblood flow of ovarian artery, the minimal flow velocity of diastolic end and the resistant index have no significance between the focus site and the opposite site of the ovary in cases of study group（P 〉 0. 05 ）. Conclusion Modified protocol of laparoscopic conservative surgery for tubal pregnancy can provide new bases and the reference to recovery the tubal function, that is better than the conservative surgery.