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目的 :比较腹腔镜下治疗输卵管妊娠的三种方法的效果 ,总结手术经验及体会。方法 :2 19例病人分为 3组 ,输卵管切除术 94例 (切除组 ) ,输卵管保留性手术 6 8例 (保留组 ) ,输卵管妊娠部位注射MTX杀胚术 5 7例(药物组 )。结果 :切除组与保留组的治愈率均为 10 0 % ,hCG转阴率分别为 5 .41及 6 .5 0d ,与药物组相比差异均非常显著 ;手术时间 :保留组最长 ,其次是切除组 ,与手术方法的难易、止血程度、盆腔粘连及对侧输卵管的通畅与否有关。术后宫腔镜下输卵管插管通液 ,药物组的患侧输卵管通畅率最差。结论 :腹腔镜下输卵管切除术仍是标准手术 ,保留性手术在手术技巧上要不断改进和提高 ,手术同时要处理好盆腔和对侧附件周围的粘连 ,输卵管局部注药杀胚术后的通畅率较低 ,适于经济困难、已有子女的患者应用。
Objective: To compare the efficacy of three methods of laparoscopic treatment of tubal pregnancy, summarize the surgical experience and experience. Methods: Twenty-nine patients were divided into three groups: 94 cases of tubal resection (resection group), 68 cases of tubal retention surgery (reserved group) and 50 cases of tubal pregnancy embryos (57 cases). Results: The cure rates of the resection group and the retention group were both 100% and the hCG negative conversion rates were 5.41 and 6.50 days, respectively, which were significantly different from those in the drug group. The operation time was the longest in the retention group, followed by Is the resection group, and the difficulty of surgical methods, hemostasis, pelvic adhesions and contralateral fallopian tube patency or not. Hysteroscopic tubal intubation through the hysteroscope, the ipsilateral tubal patency rate of the drug group was the worst. Conclusions: Laparoscopic tubal resection is still the standard operation. The retention technique should be improved and improved continuously in the surgical technique. At the same time, the operation should be done to treat the adhesions around the pelvic and contralateral accessories. Lower rate, suitable for economic difficulties, patients with children have applications.