腹腔镜下输卵管切开取胚术86例临床研究.docVIP

腹腔镜下输卵管切开取胚术86例临床研究【摘要】 目的 探讨腹腔镜下输卵管切开取胚术的手术效果及临床价值。方法 对86例宫外孕患者行腹腔镜下输卵管切开取胚术进行临床分析。 结果 所有病例全部在腹腔镜下完成,手术经过顺利,无一例中转开腹,无手术并发症。手术时间最长85 min,最短20 min,平均(36±8)min。术中出血量最多150 ml,最少10 ml,平均(40±15)ml。术后1个月行子宫输卵管通液术,通畅率95.6%,术后1年发生患侧输卵管再次异位妊娠1例。 结论 腹腔镜下输卵管切开取胚术对有生育要求的患者是一种安全有效的手术方式。 【关键词】 腹腔镜;输卵管;输卵管妊娠;输卵管切开取胚术 Clinic analysis of 86 cases taking embryo By uterine tube pregnancy with the laparoscope 【Abstract】 Objective To discuss the surgical effectiveness and clinic value of taking embryo by uterine tube pregnancy with the laparoscope.Methods To select and analyse 86 hospitalized tubal pregnancy patients who suffered from taking embryo by uterine tube pregnancy with the laparoscope.Results All cases were performed with the laparoscope operation.the surgery went smoothly.They were performed successfully without any open abdominal operation or surgical complications.The longest duration of operation lasted 85 min,and the shortest lased 26 min,with the average of (36±8)min.The most intraoperation blood loss was 150 ml,and the least was 5 ml,with the average of (40±15)ml.The operation to dredge fallopian tube was performed after 1 month of the operation,and the rate of unobstructed uterine tube is 95.6%.Only I case was found in ectopic pregnancy oviductus after 1 year of the operation.Conclusion It is tested that the method of uterine tube pregnancy with laparoscope is an method operation which is safe and effective for the patients with hope of fertility. 【Key words】 Laparoscope; Tubal pregnancy;Salpingotomy taking embryo with the laparoscope 异位妊娠(下称宫外孕)是妇科常见的急腹症,如果的不到及时治疗可危及患者健康及生命。该症的病因主要有慢性输卵管炎,输卵管发育不良及畸形,输卵管子宫内膜异位症,盆腔内肿瘤压迫及牵引,孕卵外游及输卵管结扎后再通等。其发生率约占妊娠总数的2%,其中约95%以上的为输卵管妊娠[1]。 1 资料与方法 1.1 一般资料 选择2008年1月至2009年10月在我院妇科住院的未破裂型输卵管妊娠患者86例,年龄19～38岁。平均26.87岁,经产妇32例,未产妇54例,其中输卵管壶腹部妊娠62例(72.09%),峡部妊娠24例(27.91%),间质部和伞部妊娠不在本文讨论之列。停经天数42~68 d,平均46 d,病程3 h～7 d,既往有下腹部手术史14例。86例患者中,75例术前均有不同程度的腹痛,阴道流血;8例有阴道流血,无腹痛;3例无任何症状。术前查尿HCG阳性85例,B超提示:宫内未见孕囊,宫旁可见包块或回声紊乱。 1.2 手术方法