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目的对输卵管妊娠采用阴式输卵管切除术的可行性进行探讨。方法2005-06-2006-03对遵义医学院附属医院34例无盆腔炎反复发作史、腹腔出血少(估计<300mL)的输卵管妊娠患者行阴式输卵管切除术。结果34例患者手术均获成功,手术时间平均(30.4±7.2)min,手术出血量(37.5±8.6)mL,术后病率为0,体温恢复正常时间为(1.7±0.5)d,肠功能恢复正常时间为(21.6±8.0)h,住院时间(4.4±1.2)d,无术后并发症。患者术后1～6个月随诊阴道切口愈合好,无盆腔疼痛,性生活满意。结论对无盆腔炎反复发作史、腹腔出血少(估计<300mL)的输卵管妊娠患者施行阴式输卵管切除术是安全可靠的,该术式创伤小、费用较低、无腹壁瘢痕,与开腹及腹腔镜手术相比,患者容易接受。
Objective To investigate the feasibility of using vaginal tubal excision for tubal pregnancy. Methods From June 2005 to June 2006, 34 patients with tubal pregnancy without recurrence of pelvic inflammatory disease and less peritoneal bleeding (estimated <300 mL) underwent vaginal tubal resection in the affiliated hospital of Zunyi Medical College. Results All the 34 cases were operated successfully. The mean operation time was (30.4 ± 7.2) min and the amount of bleeding during operation was (37.5 ± 8.6) mL. The postoperative morbidity was 0 and the normal temperature recovery time was (1.7 ± 0.5) d. The time to return to normal was (21.6 ± 8.0) h and the length of hospital stay was (4.4 ± 1.2) days. There was no postoperative complications. Patients with 1-6 months follow-up vaginal incision healing, no pelvic pain, sexual satisfaction. Conclusions Transvaginal tubal resection is safe and reliable for patients with tubal pregnancy who have no history of recurrent pelvic inflammatory disease and less peritoneal bleeding (estimated <300 mL). The procedure is less traumatic, less expensive, has no abdominal scar, Patients are more receptive than laparoscopic surgery.