临床医学论文腹腔镜早期诊断及治疗特殊部位异位妊娠的价值.docVIP

　　 腹腔镜早期诊断及治疗特殊部位异位妊娠的价值 　　 【摘要】? 目的：探讨腹腔镜早期诊断及治疗特殊部位异位妊娠的价值。方法：回顾分析2002年7月至2007年7月经腹腔镜诊治45例特殊部位异位妊娠患者的临床资料，其中输卵管间质部妊娠23例，卵巢妊娠13例，宫角妊娠5例，腹腔妊娠2例，输卵管残端妊娠2例。结果：腹腔镜手术成功41例，成功率91.1%，平均手术时间（40.2±23.6）min，平均手术出血（66.5±35.5）ml；中转开腹4例；腹腔镜手术无术中、术后并发症发生。结论：腹腔镜用于早期诊断及治疗特殊部位异位妊娠安全可行，不断提高手术技巧，结合术中情况选择合适的手术方式，有助于提高手术成功率。 【关键词】? 妊娠，异位；输卵管间质部；卵巢；腹腔镜术 ??? The value of laparoscope in early diagnosis and treatment of special ectopic pregnancy LIU Ping,MA Chengbin,XIE Huiliang.Changning Maternity and Child Health Hospital of Shanghai,Shanghai 200051，China ??? 【Abstract】? Ｏbjective:To investigate the value of laparoscope in early diagnosis and treatment of special ectopic pregnancy.Methods:Data of forty five cases suffered from special ectopic pregnancies who were diagnosed and treated by laparoscope from July 2002 to July 2007 were retrospectively analyzed, including 23 interstitial tubal pregnancies,13 ovarian pregnancies,5 uterine horn ectopic pregnancycies，2 abdominal pregnancies, and 2 oviduct remnant pregnancies respectively.Results:Fortyone cases were operated successfully by laparoscope.The success rate was 91.1%.The average operative time was （40.2±23.6）min,and the average operation blood loss was （66.5±35.5）ml，4 cases were treated by open operations.All patients were treated without intraoperative and postoperative complications.Conclusions:Laparoscope is safe and feasible in early diagnosis and treatment of special ectopic pregnancy.Enhancing the surgery skill unceasingly,according to the situation to select appropriate surgery procedure,is helpful to enhance the surgery success ratio. ??? 【Key words】? Pregnancy,ectopic；Interstitial tubal；Ovary;Laparoscopy ??? 目前特殊部位异位妊娠多可用腹腔镜完成，且手术安全性不断提高。现回顾分析我院近５年来用腹腔镜诊治特殊部位异位妊娠４５例患者的临床资料，现把结果报道如下。 ??? 1? 资料与方法 ??? 1.1? 临床资料? 2002年7月至2007年7月我院用腹腔镜诊治特殊部位异位妊娠患者45例，占同期异位妊娠手术患者的3.5%（45/1 278）,包括输卵管间质部妊娠23例，卵巢妊娠13例，宫角妊娠5例，腹腔妊娠2例，输卵管残端妊娠2例。平均（28.4±5.2）岁。平均孕产次（1.8±0.6）次，36例有１次以上人工流产史，5例为首次妊娠，4例为二次异位妊娠，1例为体外受精—胚胎移植术后妊娠。13例有腹部手术史，其中剖宫产6例，输卵管切除术4