论文部分内容阅读
目的探讨经阴道注水腹腔镜(transvaginal hydrolaparoscopy,THL)在输卵管妊娠诊治中的临床效果和安全性。方法选择输卵管妊娠患者22例(研究组)进行THL检查和治疗,选择同期输卵管妊娠30例(对照组)行单纯药物保守治疗。记录研究组手术时间、后穹隆穿刺成功率、手术成功率、诊断符合情况、手术并发症、对侧输卵管的通畅程度等;记录两组治愈率、治愈时间、化疗药物毒副作用发生率、住院时间、住院费用等。结果THL平均手术时间(25.4±3.5)min;后穹隆穿刺成功率95.6%,20例与术前诊断符合,18例手术成功,无手术并发症发生;术中发现对侧输卵管阻塞3例;两组治愈率比较差异无统计学意义(P>0.05),但研究组治愈率有增加趋势。治愈时间、药物毒副作用发生率、住院时间对照组均大于研究组,差异有统计学意义(P<0.05),住院费用两组比较差异无统计学意义(P>0.05)。结论THL在应用于输卵管妊娠的早期诊断和治疗中既具备了单纯药物保守治疗的优势,又达到了经腹腹腔镜保守手术的效果,术中可以同时检查对侧输卵管的通畅度,为输卵管妊娠早期诊断和输卵管保守治疗开辟了新途径,有较好的应用前景。
Objective To investigate the clinical effect and safety of transvaginal hydrolaparoscopy (THL) in the diagnosis and treatment of tubal pregnancy. Methods Tubal pregnancy in 22 patients (study group) THL examination and treatment, select the same period of tubal pregnancy in 30 patients (control group) simple drug conservative treatment. Record the operation time of the study group, success rate of posterior fornix, success rate of operation, diagnosis coincidence, complications of surgery, contralateral fallopian tube patency and so on; record the cure rate, cure time, the incidence of chemotherapy drug side effects, hospital stay , Hospital expenses and so on. Results The average operation time of THL was (25.4 ± 3.5) min. The success rate of posterior fornix puncturing was 95.6%, 20 cases were consistent with preoperative diagnosis, 18 cases were successful and no operative complications occurred. Three cases had contralateral fallopian tube obstruction. There was no significant difference in cure rate (P> 0.05), but the cure rate of study group increased. The cure time, the incidence of toxic and side effects of drugs and the length of hospital stay in the control group were significantly larger than those in the study group (P <0.05). There was no significant difference in hospitalization costs between the two groups (P> 0.05). Conclusion THL used in the early diagnosis and treatment of tubal pregnancy has both the advantages of simple conservative treatment of drugs, but also achieved the effect of laparoscopic conservative surgery, surgery can check the contralateral tubal patency at the same time, for tubal pregnancy Early diagnosis and conservative treatment of tubal opened up new avenues, have a good prospect.