三种方式治疗输卵管妊娠的疗效及妊娠结局比较

目的]探讨腹腔镜、开腹手术及药物治疗输卵管妊娠的疗效及妊娠结局.方法]选择确诊为输卵管妊娠患者130例,其中腹腔镜组56例（Ⅰ组）,开腹组45例（Ⅱ组）,药物治疗组29例（Ⅲ组）,比较三组在治疗后β绒毛膜促性腺激素（β-HCG）下降至正常所需时间、有效率、治疗后患侧输卵管通畅度及1年内妊娠结局的差异.结果]Ⅰ组和Ⅱ组治疗后血β-HCG值下降至正常所需时间显著短于Ⅲ组,有效率显著高于Ⅲ组（P〈0.05）;Ⅰ组术后输卵管通畅度显著高于Ⅱ组及Ⅲ组（P〈0.05）;Ⅰ组术后1年内的宫内妊娠率、异位妊娠率与Ⅱ组及Ⅲ组比较有显著性差异（P〈0.05）.结论]腹腔镜下治疗异位妊娠可提高术后再次妊娠率,能维持妇女正常生育功能,值得临床推广应用.

Comparison of Efficacy and Pregnancy Outcome of Three Methods for the Treatment of Tubal Pregnancy

Objectivel To explore the efficacy and pregnancy outcome of laparoscope, laparotomy and medicine for the treatment of tubal pregnancy. Methods] Totally 130 patients diagnosed as tubal pregnancy were selected and divided into laparoscope group（group Ⅰ, n = 56）, laparotomy group（group Ⅱ, n = 45） and medicinal treatment group（group Ⅲ, n = 29）. The time of HCG down to normal after treatment, effective rate, tubal patency of affected side after treatment and 1-year pregnancy outcome were compared among 3 groups. Results] The time of β-HCG down to normal after treatment in group Ⅰ and group Ⅱ was markedly shorter than that in group Ⅲ, and the effective rate in group Ⅰ and group Ⅱ was markedly higher than that in group Ⅲ（ P 〈0.05）. The postoperative tubal patency in group Ⅱ was markedly higher than that in group Ⅱ and group Ⅲ（ P 〈0.05）. There were significant differences in 1-year intrauterine pregnancy rate and ectopic pregnancy rate between group Ⅰ and group Ⅱ, group Ⅲ （ P〈0. 05）. Conclusion] The laparoscope for the treatment of ectopic pregnancy can increase the pregnancy rate after surgery again and maintain normal reproductive function of women, so it is worthy of clinical application.