论文部分内容阅读
目的分析输卵管壶腹部或峡部妊娠腹腔镜保守手术后的生殖状况,以探讨最佳的手术方案。方法有生育要求的初次未破裂型输卵管壶腹部或峡部妊娠患者280例,均无内外科合并症,符合腹腔镜保守治疗标准并配合随访,均先行腹腔镜下患侧输卵管壶腹部或峡部线型切开胚胎取出术,根据有无出血及止血方法分为:无出血未缝合未电凝组(n=151)、出血缝合组(n=89)、出血电凝组(n=40),术后随访2年,比较输卵管通畅率及妊娠率。结果腹腔镜下患侧输卵管壶腹部或峡部线型切开胚胎取出术后无出血未缝合未电凝组,术后输卵管通畅率和妊娠率均显著高于出血缝合组及出血电凝组(P<0.05)。结论对于有生育要求的输卵管壶腹部或峡部妊娠患者在行腹腔镜下输卵管线型切开胚胎取出术时,注意手术技巧,尽量做到无出血不缝合、不电凝,可获得较好的妊娠结局。一旦出血缝合要优于电凝。
Objective To analyze the reproductive status of tubal ampulla or isthmic laparoscopic conservative surgery in order to explore the best surgical plan. Methods There are 280 cases of first unruptured tubal ampulla or pregnancy in the isthmus with fertility requirements. All patients had no complications of internal medicine and surgical treatment, which were in accordance with the standard of laparoscopic conservative treatment and follow-up. All patients underwent laparoscopic tubal amputation or isthmus linear Incision embryos were removed according to the presence or absence of hemorrhage and hemostasis. The patients were divided into non-coagulation group without hemorrhage (n = 151), hemorrhage suture group (n = 89), hemorrhage coagulation group (n = 40) After 2 years of follow-up, tubal patency rate and pregnancy rate were compared. Results There was no hemorrhage in the ampulla of the tubal amputation or isthmus after laparoscopic suture removal without hemorrhage. The tubal patency rate and pregnancy rate were significantly higher than those in the hemorrhage suture group and hemorrhagic coagulation group (P <0.05). Conclusion For tubal ampullary or isthmic pregnancy patients with reproductive requirements in laparoscopic tubal linear incision embryo removal surgery, pay attention to surgical techniques, as far as possible without bleeding without suture, no coagulation, get better pregnancy ending. Once the bleeding suture is better than coagulation.