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 目录 TOC \o 1-9 \h \z \u 目录 1 正文 1 文1：腹腔镜早期诊断及治疗特殊部位异位妊娠的价值 1 1 资料与方法 2 2 结 果 4 3 讨 论 4 文2：腹腔镜手术诊治特殊部位异位妊娠的价值 5 1资料与方法 6 3例均行卵巢楔形切除并电凝止血。 8 参考文摘引言： 10 原创性声明（模板） 12 文章致谢（模板） 12 正文 腹腔镜早期诊断及治疗特殊部位异位妊娠的价值 文1：腹腔镜早期诊断及治疗特殊部位异位妊娠的价值 The value of laparoscope in early diagnosis and treatment of special ectopic pregnancy LIU Ping,MA Chengbin,XIE Hui 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 :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 intetitial tubal pregnancies,13 ovarian pregnancies,5 uterine horn ectopic pregnancycies，2 abdominal pregnancies, and 2 oviduct remnant pregnancies :Fortyone cases were operated successfully by success rate was %.The average operative time was （±）min,and the average operation blood loss was （±）ml，4 cases were treated by open patients were treated without intraoperative and postoperative :Laparoscope is safe and feasible in early diagnosis and treatment of special ectopic 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；Intetitial 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 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%（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（±）岁。平均孕产次（±）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例，卵巢囊肿剥除术2例，阑尾切除术1例。 诊断 43例有明确的停经史，平均停经时间（±）d；32例有不规则阴道流血，39例有不同程度的下腹痛，2例有失血性休克代偿期表现；术前平均血βHCG （3 ±1 ）mIU/ml，术前彩超及阴道B超诊断符合率为%，以卵巢妊娠及腹腔妊娠诊断符合率最低，为％；22例后穹窿穿刺抽出不凝血。所有病例均经手术及病理组织检查后确诊。 手术方法 先于B超监视下行诊断性刮宫术，刮出物未见明显绒毛或吸出极少量绒毛。B超示吸头无法达到妊娠部位，宫角处肌层菲薄者，行腹腔镜探查术。选择气