摘要
目的探讨腹腔镜手术治疗输卵管妊娠的术式选择。方法187例输卵管妊娠根据生育要求及意愿行输卵管切除术102例，输卵管开窗术85例。结果输卵管切除术组手术时间（40．4±9．9）min，术中出血量（17．7±5．4）ml，术后住院时间（3．8±0．5）d，术后血β-hCG 7～14d降至正常，无并发症；输卵管开窗术组手术时间（88．8±10．3）min，术中出血量（80．6±4．4）ml，术后住院时间（7．4±0．9）d，术后血β-hCG 10～33d降至正常，术后并发症2例（术后腹腔出血和持续异位妊娠各1例）。116例随访6～24个月，平均18个月，输卵管切除术组60例无再次输卵管妊娠；输卵管开窗术组56例，术后行输卵管通液或碘油造影检查，37例通畅，25例宫内妊娠，2例同侧输卵管再次妊娠。结论输卵管切除术手术时间及术后住院时间均短，出血少，并发症少，是治疗输卵管妊娠首选的手术方式。输卵管开窗术仅对有生育要求患者施行，但要警惕持续性异位妊娠的发生，并注意术中如止血效果不满意时，应果断行输卵管切除术或中转开腹止血。
Objective To explore the procedure selection of laparoscopic surgery in the treatment of tubal pregnancy. Methods A total of 187 patients with tubal pregnancy was treated either by laparoscopic salpingectomy （102 patients, Group Ⅰ） or by laparoscopic oviduct fenestration （85 patients, Group Ⅱ）. Results The surgical time was 40.4±9.9 min in the Group Ⅰ and 88.8±10.3 min in the Group Ⅱ. The intraoperative blood loss was 17.7±5.4 ml in the Group Ⅰ and 80.6±4.4 ml in the Group Ⅱ. The postoperative hospital stay was 3.8±0.5 d in the Group Ⅰ and 7.4±0.9 d in the Group Ⅱ. The postoperative time to normal serum β-hCG levels was 7～14 d in the Group Ⅰ and 10～33 d in the Group Ⅱ. A follow-up was carried out in 116 patients. No recurrence of ectopic pregnancy happened in the Group Ⅰ （60 patients）. In the Group Ⅱ （56 patients） , hydrotubation or salpingography revealed patent oviduct in 37 patients, intrauterine pregnancy in 25 patients, and recurrence of tubal pregnancy at the same side in 2 patients. Conclusions Salpingectomy should be the first choice in the treatment of tubal pregnancy because of its short surgical time, short hospital stay, less intraoperative blood loss, and low complication incidence. Oviduct fenestration should be conducted only for patients with child-bearing demands, but we must be on our guard against the possibility of persistent ectopic pregnancy, and a salpingectomy or a conversion to open surgery should be performed immediately once the bleeding can not be stopped effectively during the operation.
出处
《中国微创外科杂志》
CSCD
2006年第10期787-788,共2页
Chinese Journal of Minimally Invasive Surgery
