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目的:探讨输卵管妊娠腹腔镜下开窗取胚术与药物保守治疗对输卵管再通及妊娠的影响。方法:选取161例输卵管妊娠者设为观察组,实施腹腔镜下开窗取胚术;选取125例输卵管妊娠者设为对照组,给予甲氨喋呤进行药物保守治疗。观察两组治疗前后血HCG、治疗效果、输卵管再通及妊娠率。结果:治疗后,观察组血HCG迅速降低至正常水平,优于对照组(P<0.01)。观察组与对照组治疗成功率分别为96.27%、81.60%,输卵管再通率分别为98.76%、88.80%,1年内宫内妊娠率分别为36.67%、27.78%,1年内异位妊娠率分别为2.22%、5.56%;观察组治疗效果、输卵管再通及妊娠率均优于对照组(P<0.05或P<0.01)。结论:腹腔镜下开窗取胚术治疗输卵管妊娠具有较好的临床疗效,具体体现在清除异位妊娠病灶效果确切、迅速,再通了输卵管,具有较高的宫内妊娠率,显著降低了异位妊娠的发生,显著优于药物保守治疗。
Objective: To investigate the effect of laparoscopic embryooplasty and conservative treatment on tubal recanalization and pregnancy. Methods: One hundred and sixty-one cases of tubal pregnancy were selected as the observation group and laparoscopic fenestration was performed. 125 cases of tubal pregnancy were selected as the control group and methotrexate was given conservative treatment. Two groups before and after treatment of blood HCG, treatment, tubal recanalization and pregnancy rate. Results: After treatment, HCG in the observation group decreased rapidly to the normal level, which was better than that in the control group (P <0.01). The success rates of treatment in observation group and control group were 96.27% and 81.60% respectively, and the rates of tubal recanalization were 98.76% and 88.80% respectively. The intrauterine pregnancy rates in one year were 36.67% and 27.78% respectively. The rates of ectopic pregnancy in one year were 2.22% and 5.56%. The observation group had better curative effect, recanalization and pregnancy rate than the control group (P <0.05 or P <0.01). CONCLUSION: Laparoscopic surgery for the treatment of tubal pregnancy has a good clinical curative effect, which is embodied in the ectopic pregnancy eradication effect is accurate and rapid, and then through the fallopian tube, with a high intrauterine pregnancy rate, significantly reduced The incidence of ectopic pregnancy, significantly better than conservative treatment of drugs.