腹腔镜治疗输卵管妊娠对再次妊娠的影响

目的　研究腹腔镜下行输卵管开窗手术 (简称开窗术 )保留输卵管治疗输卵管妊娠的价值。　方法　对比分析 1994年至 2 0 0 1年腹腔镜下开窗术 2 82例和输卵管切除术 (简称切除术 ) 2 6 0例患者的输卵管通畅度、宫内妊娠、重复异位妊娠和持续性异位妊娠情况。　结果　开窗术组及切除术组的宫内妊娠率分别为 6 1.8% (131/ 2 12 )和 4 0 .5 % (81/ 2 0 0 ) ,差异有显著性 (P<0 .0 1) ;开窗术组术后持续异位妊娠率及重复异位妊娠率分别为 3.3% (7/ 2 12 ) ,14 .6 % (31/ 2 12 )均高于切除组 0 ,7.5 % (15 / 2 0 0 ) ,差异有显著性 (P<0 .0 1,P<0 .0 5 )。　结论　腹腔镜下开窗术后输卵管通畅率及宫内妊娠率高 ,但其持续性异位妊娠及重复性异位妊娠率亦增加。

The effect of different treatments with laparoscope for tubal pregnancy on subsequent pregnancy

Objectives To evaluate the salpingotomy via laparoscope in the treatment of tubal pregnancy. Methods A total of 282 patients who underwent salpingotomy and 260 patients who underwent salpingectomy via laparoscope were analyzed by comparing their smoothness of the oviduct,rate of intrauterine pregnancy,recurrent ectopic pregnancy and persistent ectopic pregnancy after operation in our hospital from 1994 to 2001. Results The incidences of intrauterine pregnancy in the salpingotomy group and the salpingectomy group were 61.8 %(131/212) and 40.5 % (81/200) respectively.There was significant statistical difference between them (P<0.001).But the incidences of persistent ectopic pregnancy and recurrent ectopic pregnancy in the former group were higher than those in latter one. Conclusion Patients who underwent salpingotomy via laparoscope were superior in the smoothness of the oviduct and intrauterine pregnancy after operation.However,Higher incidences of persistent ectopic pregnancy and recurrent ectopic pregnancy were seen in this group.