腹腔镜下剥除黄体预防持续性异位妊娠的临床研究.DOCVIP

临床医学论文-腹腔镜下剥除黄体预防持续性异位妊娠的临床研究 【摘要】? 　　目的：评价腹腔镜下输卵管妊娠保守手术的同时剥除黄体预防持续性异位妊娠的临床效果。方法：采用单中心、前瞻性、随机对照的研究方法，评价146例异位妊娠患者的治疗效果，其中腹腔镜下输卵管妊娠保守手术同时剥除黄体91例为研究组，单纯腹腔镜下输卵管妊娠保守手术55例为对照组。结果：研究组持续性异位妊娠（persistent ectopic pregnancy,PEP）发生率1.1%（1/91），对照组为14.5%（8/55），两组差异有统计学意义（P0.01）。术后βHCG降至正常所需时间研究组为（11.4±5.6）d，对照组为（14.7±5.2）d，两组差异有统计学意义（P0.01）。结论：腹腔镜下输卵管妊娠保守手术同时剥除黄体是预防PEP的有效方法，其疗效优于单纯腹腔镜下保守手术。 【关键词】? 腹腔镜检查；黄体；妊娠，异位；预防 ??? 【Abstract】Ｏbjective:To evaluate the clinical effect of laparoscopic enucleation of corpus luteum with ectopic pregnancy conservative surgery for the prevention of persistent ectopic pregnancy(PEP).Methods:Use single central,prospective and random comparison research method to study the treatment effect of 146 patients with ectopic pregnancy.91 cases in study group were treated by laparoscopic conservative surgery simultaneously enucleate the pregnancy corpus luteum of ovary,55 cases in control group were treated by pure laparoscopic conservative surgery.The curative effect accounting for the clinical parameter was evaluated.Results:One case with persistent ectopic pregnancy occurred in study group with an incidence rate of 1.1%(1/91).Eight cases with persistent ectopic pregnancy occurred in control group with an incidence rate of 14.5%(8/55).The differences between the two groups had statistics significance(P0.01).After operation the HCG in study group fell to the normal level needed (11.4?.6) days.But the control group needed (14.7?.2) days(P0.01).Conclusions:Laparoscopic enucleation of corpus luteum with ectopic pregnancy conservative surgery is one of the effective methods to prevent persistent ectopic pregnancy.The treatment result surpasses the pure laparoscopic conservative surgery for the patients with ectopic pregnancy. ??? 【Key words】Laparoscopy;Corpus luteum;Pregnancy,ectopic;Prevention ??? 腹腔镜下输卵管妊娠保守性手术后常见的并发症是持续性异位妊娠（persistent ectopic pregnancy,PEP）［1］，其发生率高达3%～20%［２］。我院对异位妊娠患者采用腹腔镜下单纯保守性手术及手术同时剥除黄体两种方法治疗，对两种方法的治疗效果用单中心、前瞻性和随机性对照的研究方法进行评价，现报道如下。