腹腔镜保守手术治疗异位妊娠

目的探讨腹腔镜在异位妊娠保守手术中的应用价值。方法回顾性分析我院2000年1月～2005年12月76例有生育要求的异位妊娠腹腔镜保守手术的临床资料。结果输卵管开窗术42例，输卵管切开缝合术21例，伞端挤出术8例，患侧输卵管节段切除联合端端吻合术5例。输卵管造影76例双侧输卵管均可见美蓝生理盐水溢出。手术时间为35—105min，（58．5±19．4）min。血β—hCG均于术后3周内降至正常。61例随访1年，术后1年内35例（57．4％，35／61）获得宫内妊娠，2例（3．3％，2／61）自然流产，2例（3．3％，2／61）再次异位妊娠，余22例（36．1％，22／61）未获得妊娠。结论腹腔镜手术是异位妊娠保守手术治疗中安全、有效的方法之一，术后密切监测血中β-hCC水平，预防持续性异位妊娠发生。

Conservative Surgery by Laparoscopy for Ectopic Pregnancy

Objective To investigate the efficacy of conservative treatment with laparoscopy for patients with ectopic pregnancy. Methods From January 2000 to December 2005, 76 patients with ectopic pregnancy received conservative treatment by laparoscopy in our hospital. The data of the patients were analyzed retrospectively. Results In this series, fenestration of the Fallopian tube was performed on 42 cases, salpingostomy on 21, fimbrial expression on 8, and segmental resection and end-to-end anastomosis on 5. Salpingography showed that the Fallopian tube was patent after the operation in all of the patients. The mean operation time was （58.5± 19.4） minutes （ranged from 35 to 105 ）. The serum level of β-hCG decreased to a normal range in 3 weeks postoperation. Follow-up was available in 61 cases for 1 year, during which 35 of the eases （57.4% , 35/61 ） had intrauterine pregnancy; 2 （3.3%） had spontaneous abortion, and 2 （3.3%） showed ectopie pregnancy; the other 22 （36. 1%） had no pregnancy. Conclusions Conservative. treatment by laparoscopy is safe and effective for ectopic pregnancy. To avoid repeated eetopic pregnancy, β-hCG monitoring after the operation is necessary.