腹腔镜宫角切开取胚术在治疗宫角妊娠中的应用

目的探讨腹腔镜宫角切开取胚术治疗宫角妊娠的优势和疗效。方法回顾性分析20例经腹腔镜宫角切开取胚术治疗的宫角妊娠患者临床资料。结果 5例在腹腔镜监视下直接行负压吸引术,15例行腹腔镜下宫角切开取胚术。手术时间40～70min,平均50.15min;术中出血30～200ml,平均68ml,术中、术后无并发症发生。术后检测血清β-人绒毛膜促性腺激素(human chorionic gonadotrophin,HCG),18例均于术后1个月内降至正常,2例在2个月内降至正常。术后1个月均恢复正常月经。术后随访无异位妊娠发生。结论腹腔镜宫角切开取胚术治疗宫角妊娠具有创伤小、出血少、安全性高的优点,可最大限度的保留子宫宫角与输卵管结构及功能,值得临床推广。

Clinical application of cornual embryo removal surgery by Laparoscopic treatment for the cornual pregnancy

Objective To study advantages and efficacy of cornual embryo removal surgery by Laparoscopic treatment for the cornual pregnancy.Methods Clinical data of 20 cases with cornual pregnancy undergoing cornual embryo removal surgery by Laparoscopy were retrospectively analyzed.Results Among 20 cases with cornual pregnancy,five cases were taken vacuum aspiration directly under the laparoscopic surveillance,15 cases were made cornual embryo removal surgery to remove pregnancy tissue material by therapeutic laparoscopy to incision horn of uterus.The average operation time was 50.15 min from 40 min to 70 min and the average hemorrhage volume was 68 ml between 30 ml and 200 ml.No intra-operative or post-operative complications occurred.Postoperative levels of serum β-HCG of 18 cases were down to normal level within 1 month after surgery while the other 2 patients returned to normal within 2 months.All patients had recovered to normal menstrual 1 month after the surgery.Up to now,no patients had ectopic pregnancy.Conclusion The treatment of cornual embryo removal surgery by Laparoscopic with less trauma,less bleeding,high security,utmost retaining uterine horn and structure and function of fallopian tube is worth wide clinical application.