论文部分内容阅读
目的 评估可疑异位妊娠 (ectopicpregnancy ,EP)患者腹腔镜 (laparoscopy ,LSC)早期诊断和急诊手术的临床价值。方法 回顾分析 1998年 8月至 2 0 0 3年 8月收治的经LSC手术治疗的可疑EP患者 186例 ,均在入院 2 4h内接受急诊LSC手术。结果 185例手术经腹腔镜完成 ,1例中转开腹 ,均无并发症发生。术中诊断EP172例 (均经病理证实 ) ,术前诊断符合率 92 5 % ;其余病例依次为卵巢囊肿 9例 ( 4 8% ) ,宫内妊娠黄体破裂 5例( 2 7% )。 32例合并不孕患者中 2 5例有盆腔粘连 ,17例有输卵管卵巢病变 ,均行相应处理。 12例少见异位妊娠(包括 4例输卵管间质部妊娠 ,4例卵巢妊娠 ,3例腹腔妊娠 ,1例子宫肌壁间妊娠 ) ,15例休克型异位妊娠 ,经腹腔镜手术亦获满意治疗效果。结论 急诊LSC手术不仅可早期确诊可疑EP患者 ,为保守性治疗赢得时间 ,而且还可同时对不孕症患者进行诊治。急诊LSC手术治疗休克型及少见异位妊娠亦是可行且安全的
Objective To evaluate the clinical value of laparoscopy (LSC) early diagnosis and emergency surgery in patients with ectopic pregnancy (EP). Methods A retrospective analysis of 186 patients with suspicious EP treated by LSC surgery from August 1998 to August 2003 was performed LSC surgery within 24 hours of admission. Results 185 cases of laparoscopic surgery completed, 1 case of laparotomy, no complications. Intraoperative diagnosis of EP172 cases (both confirmed by pathology), preoperative diagnosis consistent rate of 92.5%; the rest of the cases were ovarian cysts in 9 cases (48%), intrauterine pregnancy luteal rupture in 5 cases (27%). In 32 cases of infertility patients, 25 cases had pelvic adhesions, and 17 cases had tubal ovarian lesions, all of which were treated accordingly. 12 cases of rare ectopic pregnancy (including 4 tubal interstitial pregnancy, 4 cases of ovarian pregnancy, 3 cases of intrauterine pregnancy, 1 case of uterine muscle wall pregnancy), 15 cases of shock ectopic pregnancy, laparoscopic surgery was satisfactory treatment effect. Conclusions Emergency LSC surgery can not only diagnose suspicious EP patients early, but also win the time for conservative treatment. At the same time, it can diagnose and treat infertility patients. Emergency LSC surgical treatment of shock and rare ectopic pregnancy is feasible and safe