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腹腔镜下输卵管妊娠新型切开取胚术的临床研究

78 CHINA MEDICINE AND PHARMACY Vol.8 No.14 July

腹腔镜下输卵管妊娠新型切开取胚术的临床研究

2018

2018年7月第8卷第14期

·妇产医学·

腹腔镜下输卵管妊娠新型切开取胚术的临床研究

任?旭 孙利华

南方医科大学南海医院,广东佛山 528244

[摘要]目的?分析腹腔镜下输卵管妊娠新型切开取胚术的效果。方法 收集2016年5月~2017年12月期间在我院住院的输卵管妊娠患者100例,随机分为观察组及对照组各50例,观察组50例患者实施腹腔镜下新型切开取胚术,对照组50例患者实施传统腹腔镜下切开取胚术。结果 观察组输卵管妊娠患者术中出血量、手术时间均优于对照组患者(P <0.05),观察组持续异位妊娠例数、24h HCG 下降50%比率及输卵管通畅情况均明显优于对照组(P <0.05)。结论 通过对输卵管妊娠患者实施腹腔镜下新型切开取胚术,能缩短手术时间、减少术中出血,并提高术后输卵管的复通率,减少持续性异位妊娠几率,所以我们认为腹腔镜下输卵管妊娠的新型切开取胚术优于传统腹腔镜下切开取胚术,可以作为输卵管妊娠且有生育要求的患者行保守性手术的首选。

[关键词]腹腔镜;输卵管妊娠;新型切开取胚术;临床研究

[中图分类号]?R713.8 [文献标识码]?A [文章编号]?2095-0616(2018)14-78-04

Clinical study of new incision and extraction of embryo for tubal

pregnancy under laparoscope

REN?Xu SUN?Lihua

Nanhai Hospital of Southern Medical University, Foshan 528244, China

[Abstract] Objective To analyze the effect of new incision and extraction of embryo for tubal pregnancy under laparoscope. Methods From May 2016 to December 2017, 100 cases of tubal pregnancy patients in our hospital were selected and randomly divided into observation group and control group with 50 cases in each group. The observation group were treated with laparoscopic new incision and extraction of embryo, the control group were treated with traditional laparoscopic incision and extraction of embryo. Results The intraoperative blood loss and operative time in the observation group were better than those in the control group(P <0.05). The number of ectopic pregnancy cases, the ratio of 24 hour HCG decreased 50% and the patency of fallopian tubes in the observation group were significantly better than those in the control group(P <0.05). Conclusion Through the application of laparoscopic new incision and extraction of embryo to the patients with tubal pregnancy, it can shorten the operation time, reduce the intraoperative bleeding, improve the recovery rate of the oviduct, and reduce the probability of persistent ectopic pregnancy, so we think that laparoscopic new incision and extraction of embryo is better than traditional laparoscopic incision and extraction of embryo, can be used as tubal pregnancy and fertility requirements of patients undergoing conservative surgery is preferred.[Key words] Laparoscopy; Tubal pregnancy; New incision and embryo extraction; Clinical study

[基金项目]广东省科技厅科技计划项目(2014A020212006)。

近年来,输卵管妊娠发病率呈上升趋势,输卵管妊娠是临床中十分常见的异位妊娠,主要是指受精卵种植在女性的输卵管部位,以阴道不规则流血、腹痛和停经作为主要症状。输卵管妊娠早期诊断依赖于阴道彩超与血 β-HCG 值联合检查。随着放免法测定血 β-HCG 的敏感性增强、妇科彩超的普及及腹腔镜技术在输卵管妊娠诊断及治疗中的应用,输卵管妊娠的早期诊断和治疗有了飞跃性的发展。而对于该类患者,实施一项十分有效并损伤最小的手术治疗十分重要

[1-2]

。因此,我院将输

卵管妊娠患者100例作为研究对象,分别实施腹腔镜输卵管妊娠新型切开取胚术及传统腹腔镜下输

卵管切开取胚术,比较两种保守性手术术后的肛门排气时间、手术时间、出血量、持续性异位妊娠率及输卵管复通情况等结局。1?资料与方法1.1?一般资料

选取我院输卵管妊娠患者一共100例,收住时间为2016年5月~2017年12月,并将其随机分为腹腔镜新型手术组即观察组、传统腹腔镜手术组即对照组各50例。年龄18~36岁,未婚20例,已婚未育36例,已生育44例,均有生育要求,两组年龄差异、生育情况均无明显差异(P >0.05)。观察组、对照组两组患者均经过我院医学伦理委员会批准和同意、均签署知情同意书。