CAJ | 학술논문

目的：探讨腹腔镜下贯穿缝扎术用于保守治疗宫角妊娠及输卵管间质部妊娠的优势和疗效。方法：回顾性分析我院宫角妊娠及输卵管间质部妊娠腹腔镜手术患者19例，设为观察组和对照组。对照组采用腹腔镜下患侧宫角楔形切除及输卵管切除术，观察组行腹腔镜下患侧宫角贯穿缝扎后开窗取胚+甲氨蝶呤（MTX）病灶局部注射术，将2组的手术治疗效果进行对比。结果：观察组与对照组相比，术中出血量少、手术时间短，差异有统计学意义（P＜0.05）。术后随访血β-hCG，2组均于60d内降至正常，所有患者于3个月内恢复月经来潮。结论：腹腔镜下贯穿缝扎+开窗取胚+MTX病灶局部注射保守治疗宫角妊娠及输卵管间质部妊娠，操作简便、手术时间短、创伤小、出血少、可保留子宫及输卵管的结构及形态，具有临床实用性。
목적：탐토복강경하관천봉찰술용우보수치료궁각임신급수란관간질부임신적우세화료효。방법：회고성분석아원궁각임신급수란관간질부임신복강경수술환자19례，설위관찰조화대조조。대조조채용복강경하환측궁각설형절제급수란관절제술，관찰조행복강경하환측궁각관천봉찰후개창취배+갑안접령（MTX）병조국부주사술，장2조적수술치료효과진행대비。결과：관찰조여대조조상비，술중출혈량소、수술시간단，차이유통계학의의（P＜0.05）。술후수방혈β-hCG，2조균우60d내강지정상，소유환자우3개월내회복월경래조。결론：복강경하관천봉찰+개창취배+MTX병조국부주사보수치료궁각임신급수란관간질부임신，조작간편、수술시간단、창상소、출혈소、가보류자궁급수란관적결구급형태，구유림상실용성。
Objective: To evaluate the beneift and efifcacy of conservative treatment with suture surgery under laparoscope for the cornual or interstitial tubal pregnancy.Methods: Clinical data of 19 cases with cor-nual or interstitial tubal pregnancy undergoing surgery by laparoscopic treatment were retrospectively analyzed. They were designed to observation group and control group. The patients in observation group received suture surgery and taking embryo by cornual or tube pregnancy incision by laparoscope combined with partly injection on methotrexate (MTX), and those in control group received one horn of uterus wedge resection or one tubal re-moval by Laparoscope.Results: Comparing the control group, the observation group patients had the advantages of less bleeding, shorter duration of surgery. Between the two groups, the difference was statistically signiifcant (P<0.05). Postoperative levels of serum β-HCG of 19 cases decreased to normal level within 60 days after sur-gery. All patients recovered to normal menstrual 3 months after the surgery.Conclusion: The method of through suture surgery and taking embryo by cornual or tube pregnancy incision combined with partly injection on meth-otrexate (MTX) by laparoscopic conservative treatment with the advantages of operation simply, shorter duration of surgery, less trauma, less bleeding, utmost retaining the structure and function of uterine and fallopian tube is worth in wide clinical application.