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目的观察腹腔镜两种手术方式治疗输卵管妊娠的围手术及再次妊娠情况。方法对滁州市第二人民医院2004年4月-2008年12月期间收治的输卵管妊娠患者行腹腔镜手术治疗,其中Ⅰ组:保守性手术28例;Ⅱ组:输卵管切除术42例。比较两组手术时间、出血量、手术结局、术后再次妊娠情况。结果Ⅰ组手术时间、出血量均高于Ⅱ组,差异有统计学意义(P<0.05);持续性异位妊娠Ⅰ组高于Ⅱ组;再次宫内妊娠及异位妊娠,Ⅰ组高于Ⅱ组,差异无统计学意义(P>0.05)。结论腹腔镜保守性手术难度、术后持续性异位妊娠及再次妊娠率均高于输卵管切除术,但再次妊娠与对侧输卵管及盆腔病变情况有关,在对侧输卵管正常,而患侧输卵管病变严重的情况下则行患侧输卵管切除术。
Objective To observe the two kinds of laparoscopic surgical treatment of tubal pregnancy perioperative and pregnancy again. Methods Laparoscopic surgery was performed in patients with tubal pregnancy admitted to the Second People’s Hospital of Chuzhou from April 2004 to December 2008, in which group Ⅰ was treated conservatively in 28 cases and in group Ⅱ 42 cases were tubal excision. The operation time, blood loss, surgical outcome and post-pregnancy pregnancy were compared between the two groups. Results The operation time and blood loss in group Ⅰ were significantly higher than those in group Ⅱ (P <0.05), while those in group Ⅰ were higher than those in group Ⅱ. The intrauterine pregnancy and ectopic pregnancy in group Ⅰ were higher than those in group Ⅰ Ⅱ group, the difference was not statistically significant (P> 0.05). Conclusions The difficulty of laparoscopic conservative surgery, postoperative persistent ectopic pregnancy and re-pregnancy rate are higher than that of tubal resection, but the second pregnancy is related to the contralateral fallopian tube and pelvic lesions, contralateral fallopian tube is normal, and ipsilateral tubal lesions In severe cases, ipsilateral tubal resection.