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腹腔镜宫角切开术治疗直径小于3cm的输卵管间质部妊娠的临床疗效

[The clinical efficacy of laparoscopic cornuotomy on interstitial tubal pregnancy which diameter was shorter than 3 cm].

作者信息

Jin Q Y, Jin X Y, Zhang S Y

机构信息

Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China.

Department of Gynecology, Jiaxing Maternity and Child Health care Hospital, Jiaxing 314051, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2020 Apr 14;100(14):1077-1080. doi: 10.3760/cma.j.cn112137-20191122-02547.

Abstract

To investigate the clinical efficacy of Laparoscopic cornuotomy on Interstitial Tubal Pregnancy (IP) which diameter was shorter than 3 cm. The women who had IP under 3 cm diameter were selected from January, 2016 to December, 2018 at the Department of Gynecology, JiaXing Maternity and Child Health care Hospital. A total of 32 IP patients were divided into two groups. They were all treated with laparoscopic surgery. 17 patients were in study group, conducted by a cornuotomy and suturing the cornual.15 patients were in control group, conducted by a cornual resection and suturing the cornual. Patients' genenral conditions were not significantly different(all values>0.05). The peri-surgical data and the related clinical data were compared in the two groups. All the 32 patients were successfully treated by laparoscopic surgery. The mean operating time was significantly shorter for cornuotomy than for cornual resection[ (33±6) min vs (53±9) min, 0.05].Changes in blood loss[(45±5) ml vs (50±7) ml]、the total hospital stays[ (4.4±1.4) d vs (4.6±1.4) d] and the recovery time of HCG[(16±5) d vs (15±5) d] were not significantly different between the two groups (all values>0.05) . There were no persistent ectopic pregnancy and uterine rupture happened in two groups. Compared with the control group,the interval time to pregnancy was shorter[ (8±3) m vs (16±4) m, 0.05] and the number of full-term pregnancy cases were more (9 vs 3, 0.05). The Laparoscopic cornuotomy was feasible and safe on interstitial tubal pregnancy which diameter was shorter than 3cm. It deserved popularization in the clinical work and regarded as one of selection operative treatment on interstitial heterotopic pregnancy.

摘要

探讨腹腔镜子宫角部切开术治疗直径小于3cm的输卵管间质部妊娠(IP)的临床疗效。选取2016年1月至2018年12月在嘉兴市妇幼保健院妇科就诊的直径小于3cm的IP患者。将32例IP患者分为两组,均行腹腔镜手术。研究组17例,行子宫角部切开并缝合子宫角;对照组15例,行子宫角切除术并缝合子宫角。两组患者一般情况差异无统计学意义(所有P值>0.05)。比较两组围手术期数据及相关临床资料。32例患者均成功行腹腔镜手术。子宫角部切开术的平均手术时间明显短于子宫角切除术[(33±6)分钟对(53±9)分钟,P<0.05]。两组术中出血量[(45±5)ml对(50±7)ml]、总住院天数[(4.4±1.4)天对(4.6±1.4)天]及血β-HCG恢复时间[(16±5)天对(15±5)天]差异无统计学意义(所有P值>0.05)。两组均未发生持续性异位妊娠及子宫破裂。与对照组相比,研究组术后再次妊娠间隔时间较短[(8±3)个月对(16±4)个月,P<0.05],足月妊娠例数较多(9例对3例,P<0.05)。腹腔镜子宫角部切开术治疗直径小于3cm的输卵管间质部妊娠可行、安全,值得临床推广,可作为输卵管间质部妊娠的手术治疗选择之一。

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