腹腔镜下缝扎术保守治疗宫角及输卵管#br# 间质部妊娠

目的：探讨腹腔镜下贯穿缝扎术用于保守治疗宫角妊娠及输卵管间质部妊娠的优势和疗效。方法：回顾性分析我院宫角妊娠及输卵管间质部妊娠腹腔镜手术患者19例，设为观察组和对照组。对照组采用腹腔镜下患侧宫角楔形切除及输卵管切除术，观察组行腹腔镜下患侧宫角贯穿缝扎后开窗取胚+甲氨蝶呤（MTX）病灶局部注射术，将2组的手术治疗效果进行对比。结果：观察组与对照组相比，术中出血量少、手术时间短，差异有统计学意义（P＜0.05）。术后随访血β-hCG，2组均于60 d内降至正常，所有患者于3个月内恢复月经来潮。结论：腹腔镜下贯穿缝扎+开窗取胚+MTX病灶局部注射保守治疗宫角妊娠及输卵管间质部妊娠，操作简便、手术时间短、创伤小、出血少、可保留子宫及输卵管的结构及形态，具有临床实用性。

Conservative treatment with suture surgery under laparoscope for the cornual or interstitial tubal pregnancy

Objective: To evaluate the benefit and efficacy of conservative treatment with suture surgery under laparoscope for the cornual or interstitial tubal pregnancy. Methods: Clinical data of 19 cases with cornual or interstitial tubal pregnancy undergoing surgery by laparoscopic treatment were retrospectively analyzed. They were designed to observation group and control group. The patients in observation group received suture surgery and taking embryo by cornual or tube pregnancy incision by laparoscope combined with partly injection on methotrexate (MTX), and those in control group received one horn of uterus wedge resection or one tubal removal by Laparoscope. Results: Comparing the control group, the observation group patients had the advantages of less bleeding, shorter duration of surgery. Between the two groups, the difference was statistically significant (P<0.05). Postoperative levels of serum β-HCG of 19 cases decreased to normal level within 60 days after surgery. All patients recovered to normal menstrual 3 months after the surgery. Conclusion: The method of through suture surgery and taking embryo by cornual or tube pregnancy incision combined with partly injection on methotrexate (MTX) by laparoscopic conservative treatment with the advantages of operation simply, shorter duration of surgery, less trauma, less bleeding, utmost retaining the structure and function of uterine and fallopian tube is worth in wide clinical application.