【摘要】 目的　比较腹腔镜和剖腹手术在保守性治疗未破裂型输卵管妊娠的效果。　方法　选取经临床或腹腔镜确诊的输卵管峡部、壶腹部或伞部妊娠的未破裂型住院病例 ,分成腹腔镜手术和剖腹手术 2组进行保守性手术治疗 ,2组各 112例 ,记录术前病史体征、术中和术后情况 ,并随访其术后 1年内的妊娠结局。　结果　腹腔镜组术中出血量 (30 .6± 13.8) m l、手术时间(4 1.3± 11.2 ) m in、排气时间 (11.5± 5 .3) h、抗生素应用时间 (2 .6± 2 .1) d、术后最高体温 (36 .8± 0 .4 )℃、术后住院时间 (4 .3± 1.2 ) d及术后 3个月后子宫输卵管造影 (hystero salpingo graphy,HSG)通畅率 83.9% (78/ 112 ) ,明显优于剖腹组 (P<0 .0 5 ) ;腹腔镜组和剖腹组术后血β- HCG恢复正常时间分别为 (9.6± 5 .1) d、(10 .2± 4 .9) d;术后发生持续性宫外孕率分别为 (6 .3% ,5 .4 % )、术后 1年内的宫内妊娠率分别为 (87.9%、 76 .5 % )及宫外孕发生率分别为 (12 .6 % ,2 3.5 % ) ,2组间差异无显著 (P>0 .0 5 )。　结论　腹腔镜保守治疗未破裂型输卵管妊娠具有手术时间短、出血少、术后恢复块、 HSG通畅率高更多还原

【Abstract】 Objective To compare the value of conservative treatment for unruptured tubal pregnancy with laparoscopy and laparotomy. Methods 224 cases of tubal pregnancy that had been diagnosed by clinical or laparoscopy were distributed randomly to the laparoscopy gruop (112 cases) and laparotomy group (112 cases).Their preoperative history,detection in operation,postoperative recovery and postoperative pregnancy outcome within one year were recorded. Results Bleeding in operation (30.6±13.8) ml,operative time (41.3±11.2) min,the antibiotic time (2.6±2.1) d,functional recover time of bowel (11.5±5.3) h,length of stay(4.3±1.2) d,the highest temperature (36.8±0.4) ℃,and HSG outcome 83.9 %(78/112)after three months in the laparoscopy group were better than in the laparotomy group(P<0.05).The postoperative incidences of persistent ectopic pregnancy(6.3 %;5.4 % respectively),the rate of intra-uterine pregnancy(87.9 %; 76.5 % respectively) and the rate of ectopic pregnancy (12.6 %;23.5 % respectively) within one year,and the time of serum β-HCG value reduced to normal [(9.6±5.1) d;(10.2±4.9) d respcectively] had no difference between the two groups (P>0.05). Conclusions Conservative treatment for unruptured tubal pregnancy with laparoscopy is better than laparotomy in postoperative recovery and pregnancy outcome.更多还原