药物水压胚胎分离法腹腔镜手术治疗输卵管妊娠58例疗效观察

Clinical observation of tubal pregnancy treated by medicine water pressure embryo separation (58 cases)

摘要:

目的 探讨药物水压胚胎分离法保守性腹腔镜手术治疗输卵管妊娠的安全性和有效性。方法 对输卵管妊娠未破裂的58例患者，先向病灶内部注射甲氨蝶呤（MTX）稀释液3～5 ml，再向近子宫角处输卵管壁周围注射3 ml MTX稀释液，然后行保留输卵管腹腔镜下胚胎清除术。结果 术后2周监测血β-人绒毛膜促性腺激素（β-HCG），均降至正常。平均随访18个月，无1例持续性异位妊娠发生，输卵管造影通畅，22例已婚者，宫内妊娠16例（72.73%）。结论 采取MTX稀释液水压分离妊娠病灶和近端输卵管MTX注射法腹腔镜保守性手术治疗输卵管妊娠，疗效确切，保留了输卵管的正常解剖和生理功能，是治疗输卵管妊娠安全有效的好方法。

Abstract:

Objective To investigate the safety and efficacy of the conservative laparoscopic operation in treatment of tubal pregnancy by drug water pressure embryo separation. Method 58 cases with tubal pregnancy without rupture, the first focus on internal injection of MTX dilution 5 ml to 3 ml, and then to the near corner of the uterus injection of 3 ml MTX dilution, and then the line to retain the fallopian tube laparoscopic embryo removal. Results After 2 weeks, the blood β-HCG was monitored, and the average follow-up was 18 months. There was no persistent ectopic pregnancy, the fallopian tube was unobstructed, 22 cases were married of 16 cases (72.73 %) in the intrauterine pregnancy. Conclusion Separation of ectopic pregnancy and proximal tubal MTX injection method laparoscopic conservative surgery in the treatment of fallopian tube pregnancy by methotrexate(MTX) dilution water pressure, curative effect is exact, retained the fallopian tube of the normal anatomy and physiological function treatment of tubal pregnancy is safe and effective method.