中国实用医刊
中國實用醫刊
중국실용의간
CENTRAL PLAINS MEDICAL JOURNAL
2014年
10期
45-47
,共3页
封全灵%丁俊珊%李秋芳%刘弘扬%王红丽
封全靈%丁俊珊%李鞦芳%劉弘颺%王紅麗
봉전령%정준산%리추방%류홍양%왕홍려
腹腔镜%输卵管壶腹部妊娠%输卵管切除术%输卵管切开取胚术
腹腔鏡%輸卵管壺腹部妊娠%輸卵管切除術%輸卵管切開取胚術
복강경%수란관호복부임신%수란관절제술%수란관절개취배술
Laparoscopy%Tubal ampullary pregnancy%Salpingectomy%Tubal incision and suture
目的 探讨腹腔镜下两种术式治疗输卵管壶腹部妊娠的效果.方法 对2011年1月至8月就诊于郑州大学第三附属医学院并接受腹腔镜手术的176例输卵管壶腹部妊娠患者进行回顾性分析.根据其手术方式分为输卵管切除术56例(根治组),输卵管切开取胚术120例(保守组).对比分析两组手术时间、术中出血、术后血绒毛膜促性腺激素(T-HCG)下降情况.随访有生育要求的患者24 ～ 32个月,分析其再次妊娠情况.结果 ①根治组与保守组手术时间、术中出血、术后第3天血T-HCG下降比率等差异无统计学意义;②成功随访有生育要求患者共115例,其中根治组32例,保守组83例.根治组:宫内妊娠13例(40.63％),异位妊娠9例(28.12％),继发不孕10例(31.25％).保守组:宫内妊娠33例(39.76％),异位妊娠25例(30.12％),继发不孕25例(30.12％).两组宫内妊娠率、异位妊娠率、继发不孕率比较差异均无统计学意义.结论 腹腔镜输卵管切除术在治疗输卵管壶腹部妊娠方面与输卵管切开取胚术有相同的治疗价值,同时预防性地切除输卵管可以降低卵巢癌的发病风险,所以腹腔镜输卵管切除术可以作为输卵管壶腹部妊娠的首选手段.
目的 探討腹腔鏡下兩種術式治療輸卵管壺腹部妊娠的效果.方法 對2011年1月至8月就診于鄭州大學第三附屬醫學院併接受腹腔鏡手術的176例輸卵管壺腹部妊娠患者進行迴顧性分析.根據其手術方式分為輸卵管切除術56例(根治組),輸卵管切開取胚術120例(保守組).對比分析兩組手術時間、術中齣血、術後血絨毛膜促性腺激素(T-HCG)下降情況.隨訪有生育要求的患者24 ～ 32箇月,分析其再次妊娠情況.結果 ①根治組與保守組手術時間、術中齣血、術後第3天血T-HCG下降比率等差異無統計學意義;②成功隨訪有生育要求患者共115例,其中根治組32例,保守組83例.根治組:宮內妊娠13例(40.63％),異位妊娠9例(28.12％),繼髮不孕10例(31.25％).保守組:宮內妊娠33例(39.76％),異位妊娠25例(30.12％),繼髮不孕25例(30.12％).兩組宮內妊娠率、異位妊娠率、繼髮不孕率比較差異均無統計學意義.結論 腹腔鏡輸卵管切除術在治療輸卵管壺腹部妊娠方麵與輸卵管切開取胚術有相同的治療價值,同時預防性地切除輸卵管可以降低卵巢癌的髮病風險,所以腹腔鏡輸卵管切除術可以作為輸卵管壺腹部妊娠的首選手段.
목적 탐토복강경하량충술식치료수란관호복부임신적효과.방법 대2011년1월지8월취진우정주대학제삼부속의학원병접수복강경수술적176례수란관호복부임신환자진행회고성분석.근거기수술방식분위수란관절제술56례(근치조),수란관절개취배술120례(보수조).대비분석량조수술시간、술중출혈、술후혈융모막촉성선격소(T-HCG)하강정황.수방유생육요구적환자24 ～ 32개월,분석기재차임신정황.결과 ①근치조여보수조수술시간、술중출혈、술후제3천혈T-HCG하강비솔등차이무통계학의의;②성공수방유생육요구환자공115례,기중근치조32례,보수조83례.근치조:궁내임신13례(40.63％),이위임신9례(28.12％),계발불잉10례(31.25％).보수조:궁내임신33례(39.76％),이위임신25례(30.12％),계발불잉25례(30.12％).량조궁내임신솔、이위임신솔、계발불잉솔비교차이균무통계학의의.결론 복강경수란관절제술재치료수란관호복부임신방면여수란관절개취배술유상동적치료개치,동시예방성지절제수란관가이강저란소암적발병풍험,소이복강경수란관절제술가이작위수란관호복부임신적수선수단.
Objective To investigate the effect of two laparoscopic surgical manners on tubal ampullary pregnancy.Methods The clinical data of 176 patients with tube ampullary pregnancy underwent laparoscopic operation in the third affiliated hospital of Zhengzhou university from January to August in 2011 were retrospectively analyzed.According to the operation mode,the 176 patients were divided into two groups:56 cases of tubal resection as radical treatment group and 120 cases of salpingotomy in conservative group.The operation time,amount of intraoperative bleeding and the postoperative blood T-HCG decline level of the two groups was compared and analyzed.The patients with fertility requirement were followed-up for 24 to 32 months after the surgery,and the conditions of re-pregnancy were analyzed.Results ①The operation time,amount of intraoperative bleeding,blood T-HCG drop ratio of postoperative third day of the two groups had no significant difference ; ②115 cases with fertility requirements had been successfully followed-up,including 32 cases in radication group and 83 cases in conservation group.In radical group:13 cases (40.63％) of pregnancy,9 cases (28.12％) of ectopic pregnancy and 10 cases (31.25％)of secondary infertility.In conservative group:33 cases (39.76％) of pregnancy,25 cases (30.12％) of ectopic pregnancy,and 25 cases (30.12％) of secondary infertility.The intrauterine pregnancy rate,ectopic pregnancy and infertility rate between the two groups showed no statistical difference.Conclusions Laparoscopic tubal resection has the same therapeutic value as the salpingotomy in the treatment of tubal ampullary pregnancy,and preventively resect tubal can reduce the risk of ovarian cancer.So the laparoscopic tubal resection can be used as the preferred means for treating tubal ampullary pregnancy.
