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目的:探讨腹腔镜下输卵管间质部妊娠切开取胚术辅以患侧宫角及输卵管系膜注射垂体后叶素及宫角肌层内注射MTX可行性。方法:回顾分析2006年6月至2010年10月我科以腹腔镜治疗13例输卵管间质部妊娠的手术时间、术中失血量、β-HCG下降、持续性异位妊娠发生情况。结果:13例患者均在腹腔镜下明确诊断并完成手术,无术中及术后并发症。手术时间30～60min,平均47min;术中失血20～250ml,术后48小时及第五天测血β-HCG均进行性下降,术后5天复查血常规WBC及BPC正常范围,术后随访β-HCG直至正常,无持续性异位妊娠发生。结论:腹腔镜下输卵管间质部妊娠切开取胚术辅以患侧宫角及输卵管系膜注射垂体后叶素及宫角肌层内注射MTX是一项值得推广的技术。
OBJECTIVE: To investigate the feasibility of laparoscopic tubal interstitial pregnancy embryo excision combined with injection of MTX in posterior pterygium and tubal pituitary and intracavernosal injection of MTX. Methods: From June 2006 to October 2010, we retrospectively analyzed the operation time, intraoperative blood loss, the decline of β-HCG and the occurrence of persistent ectopic pregnancy in 13 cases of tubal interstitial pregnancy treated with laparoscopy. Results: Thirteen patients were diagnosed laparoscopically and completed the operation without intraoperative and postoperative complications. The operation time was 30-60min with an average of 47min. The intraoperative blood loss was 20-250ml. The levels of β-HCG decreased 48 hours after operation and on the fifth day after operation. The normal ranges of WBC and BPC were observed 5 days after operation. β-HCG until normal, no persistent ectopic pregnancy. CONCLUSION: Laparoscopic tubal interstitial pregnancy embryo excision and embryo implantation combined with ipsilateral uterine horn and tubal injection of pituitrin and intramyocular muscle injection of MTX is a worthy technique.