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目的:探讨药物及腹腔镜、开腹保守手术治疗输卵管妊娠的近远期疗效,选择对有生育要求的输卵管妊娠妇女最适合的治疗方法。方法:选择河北联合大学附属医院2009～2011年收治的124例输卵管妊娠患者,其中药物组44例、开腹组32例、腹腔镜组48例,对3组患者治疗后的疗效进行分析。结果:腹腔镜组术前血β-HCG水平、血HCG下降至正常的天数、月经恢复正常的天数与开腹组比较差异无统计学意义(P>0.05);腹腔镜组手术时间、术中出血量、术后肛门排气时间、抗生素应用时间、住院天数与开腹组比较差异有统计学意义(P<0.05);药物组初始血β-HCG水平、住院天数、血HCG下降至正常的天数、月经恢复正常的天数与保守性手术组比较差异具有统计学意义(P<0.05)。远期随访结果显示,腹腔镜组输卵管通畅率明显高于药物组和开腹组,药物组与开腹组比较差异无统计学意义。结论:腹腔镜、开腹保守手术治疗输卵管妊娠与药物治疗比较,具有住院时间短、血HCG下降快、输卵管通畅率高等优点,腹腔镜组与开腹组比较,具有术中出血少、手术时间短、抗生素应用时间短、住院时间短、输卵管通畅率高等优点,所以对于有生育要求的输卵管妊娠患者,腹腔镜保守性手术是合适的治疗方法。
OBJECTIVE: To explore the short-term and long-term effects of drugs and laparoscopic surgery and laparotomy for tubal pregnancy, and select the most appropriate treatment for women with tubal pregnancy requiring fertility. Methods: A total of 124 tubal pregnancy patients admitted to the Affiliated Hospital of Hebei Union University from 2009 to 2011 were enrolled. Among them, 44 were in the drug group, 32 in the open group, and 48 in the laparoscopic group. The curative effect of the three groups was analyzed. Results: There was no significant difference between the laparoscopic group before operation and the laparotomy (P> 0.05). There was no significant difference between the laparoscopic group and the laparotomy group (P> 0.05) Bleeding time, postoperative anal exhaust time, antibiotic application time, days of hospitalization and open group were significantly different (P <0.05); initial blood β-HCG level, length of hospital stay, blood HCG decreased to normal The number of days and normal menstruation days compared with the conservative surgery group was statistically significant (P <0.05). Long-term follow-up results show that the laparoscopic tubal patency rate was significantly higher than the drug group and open group, drug group and open group compared with no significant difference. Conclusion: Laparoscopic and open surgical conservative treatment of tubal pregnancy compared with drug treatment, with short hospital stay, blood HCG decreased rapidly, tubal patency rate higher laparoscopic group and open group, with less bleeding, operation time Short, antibiotic application time is short, shorter hospital stay, tubal patency rate advantages, so for tubal pregnancy patients with fertility requirements, laparoscopic conservative surgery is the appropriate treatment.