Orazi G, Cosson M
Pôle de Chirurgie Gynécologique, Maternité Jeanne-de Flandre, CHRU Lille, 59037 Lille.
J Gynecol Obstet Biol Reprod (Paris). 2003 Nov;32(7 Suppl):S75-82.
Recent advances in therapeutics have considerably modified the management of ectopic pregnancy. However, surgical management is still indicated in some patients. Laparoscopic procedure is the reference surgical approach for the management of ectopic pregnancy. It reduces length of hospital stay, analgesic requirement, hospital cost, the risk of post-surgical adherence and is also associated with lower morbidity and better esthetic appearance. Laparotomy is now only performed in individuals for whom laparoscopy is contra-indicated. Patients can be treated conservatively, tubotomy with removal of the products of conception or radically, salpingectomy. In order to lower the failure rate and the risk of re-occurrence, some operative procedures are required including regular washing of the abdominal cavity, adhesiolysis and extraction in a protective bag. The choice of treatment is generally guided by the patient's past medical history and the wish to bear future children.
近年来治疗方法的进展极大地改变了异位妊娠的治疗方式。然而，在某些患者中仍需进行手术治疗。腹腔镜手术是治疗异位妊娠的标准手术方法。它可缩短住院时间、减少止痛药物需求、降低住院费用、降低术后粘连风险，且发病率较低，美观效果更好。剖腹手术目前仅用于腹腔镜手术禁忌的患者。患者可接受保守治疗，即输卵管切开术并清除妊娠产物，或进行根治性治疗，即输卵管切除术。为了降低失败率和复发风险，需要采取一些手术操作，包括定期冲洗腹腔、粘连松解和在保护袋中取出。治疗方法的选择通常取决于患者的既往病史以及生育意愿。
