可疑异位妊娠患者腹腔镜早期诊断和急诊手术的临床意义

目的：评估我院可疑异位妊娠(Ectopic pregnancy,EP)患者腹腔镜(Laparoscopy,LSC)早期诊断和急诊手术的临床价值。方法：87例可疑EP患者均在入院24h内接受急诊LSC手术。结果：所有病例手术顺利，无中转开腹和并发症发生。术中诊断EP患者76例(均病理证实)。术前诊断符合率87．4％；其余病例依次为卵巢囊肿8例(9．2％)、宫内妊娠黄体破裂3例(3.4％)。施行输卵管切除术70例(80．1％)、输卵管开窗术6例(6．9％)。卵巢囊肿刺除术8例(9．2％)。卵巢部分切除术3例(3.4％)。12例合并不孕症患者发现；10例盆腔粘连、5例输卵管卵巢病变，均行相应处理。结论：急诊LSC技术不仅可早期确诊可疑EP患者。为保守性治疗赢得时间；而且还可同时不不孕症患者进行诊治，提高受孕率。

CLINICAL SIGNIFICANCE OF EARLY DIAGNOSIS AND ACUTE OPERATION OF SUSPICIOUS ECTOPIC PREGNANCY BY LAPAROSCOPY

Objective: To evaluate the clinical value of early diagnosis and acute operation of suspicious ectopic pregnancy (EP) by laparoscopy (LSC) in our hospital. Methods:Eighty-seven cases received the emergency LSC because of the suspicious EP within 24 hours after being admitted. Results:All patients were operated successfully without subsequent laparatomy and complications. Seventy-six cases were diagnosed definitely during operation (all pathologic proof), with diagnosis before operation coincidence rate 87.4%; other cases were 8 (9.2%) ovarian cyst,3( 3.4% ) intrauterine pregnancy complicated by rupture of the pregnant corpus luteum in order. Seventy ( 80.1% ) cases had salpingectomy, 6 (6.9%) cases had salpingectomy without closure. Others were 8 (9.2%) ovarian cystectomy and 3 ( 3.4% ) partial ovary excision. Of 12 patients with infertility, there were 10 cases who had pelvic adhesion,5 had tube or ovarian lesions and they received relevant treatment.Conclusions:The emergency LSC not only can early diagnose EP definitely to gain time for conservative operation, but also can diagnose and treat infertility to increase fecundity rate.