【摘要】 目的探讨腹腔镜下更好地进行输卵管妊娠病灶清除后复通的方法。方法 2010年我科有生育要求的输卵管妊娠患者32例作为研究组,该组病例均应用自制的腹腔镜输卵管复通钳具,进行输卵管妊娠病灶清除后端-端吻合或宫角植入,将输卵管妊娠类型作为控制因素,按1:1配比;选择同时期未采用复通钳具的腹腔镜手术患者32例作为对照组,比较两组手术时间、术后β-HCG下降情况以及术后输卵管造影通畅率。结果研究组手术时间平均(67.6±19.7)min,较对照组的(43.1±16.7)min显著延长(P<0.01);研究组术后1dβ-HCG平均降为术前的(35.5±14.00)%,较对照组的(43.8±16.49)%下降明显(P<0.05);研究组术后输卵管通畅率81.3%(26/32),较对照组的56.3%(18/32)显著提高(P<0.05)。结论腹腔镜输卵管复通钳具可用于输卵管妊娠病灶清除后复通,与传统腹腔镜手术方法相比,虽增加手术时间,但治疗效果好。更多还原

【Abstract】 Objective To improve the therapeutic effect of fallopian recanalization after fallopian pregnancy resection under laparoscope.Methods 32 cases of fallopian pregnancy inpatients with fertility requirement in 2010 were reviewed as study group.All the patients underwent fallopian end-to-end anastomosis or cornual implantation after fallopian pregnancy resection.A kind of self-made laparoscopic fallopian repatency forceps was applied on the procedure.32 cases without the application of self-made laparoscopic fallopian repatency forceps were chosen as control group by 1:1 paired,taken the type of fallopian pregnancy as control factor.Operation time,the post-operative change of β-HCG,and post-operative tubal patency rate by hysterosalpingography(HSG) were observed.Results Operation time was averagely(67.6±19.7)minutes in study group,and was significantly longer than the time of(43.1±16.7)minutes in control group(P<0.01).β-HCG of the first post-operative day reduced to(35.5±14.00)% of the pre-operation.It significantly descended comparing with the rate of(43.8±16.49)% in control group(P<0.05).Post-operative tubal patency rate was 81.3%(26/32) in study group.It was significantly higher than the rate of 56.3%(18/32) in control group(P<0.05).Conclusion It is feasible to apply this kind of self-made laparoscopic fallopian repatency forceps on fallopian recanalization after fallopian pregnancy resection under laparoscope.Comparing with traditional laparoscopic operation,it achieves better therapeutic effects although increasing operation time.更多还原