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目的:比较经阴道宫腔镜手术与腹腔镜手术对输卵管妊娠的临床疗效和安全性。方法:选取2013年3月至2015年3月在我院接受治疗的输卵管妊娠患者95例,按照手术方式的不同分为对照组48例和观察组47例。对照组患者给予腹腔镜手术治疗,观察组患者给予经阴道宫腔镜手术治疗。比较两组手术时间、术中出血量、排气时间、住院时间、症状消失时间以及手术结果,炎性因子包括血清C反应蛋白(CRP)、白细胞介素2(IL-2)、白细胞介素6(IL-6)、白细胞介素8(IL-8)水平的变化。结果:两组的手术时间、术中出血量、住院时间以及症状消失时间比较差异无统计学意义(P>0.05);而观察组的排气时间显著短于对照组(P<0.05);术后,观察组的学期CRP、IL-2、IL-6、IL-8水平显著低于对照组,差异具有统计学意义(P<0.05)。两组的手术成功率、患侧输卵管通畅率比较差异无统计学意义(P>0.05);而观察组的再次宫内妊娠率显著高于对照组,不良反应发生率显著低于对照组,差异具有统计学意义(P<0.05)。结论:经阴道宫腔镜手术和腹腔镜手术治疗输卵管妊娠均效果良好,而经阴道宫腔镜手术在抑制炎症和提高再次宫内妊娠率的效果更优,且安全性更高。
Objective: To compare the clinical efficacy and safety of transvaginal hysteroscopy and laparoscopic surgery for tubal pregnancy. Methods: Ninety-five patients with tubal pregnancy treated in our hospital from March 2013 to March 2015 were selected and divided into control group (n = 48) and observation group (n = 47) according to different operation methods. Patients in the control group were treated with laparoscopic surgery, and patients in the observation group were treated by transvaginal hysteroscopy. The operation time, intraoperative blood loss, excretion time, hospital stay, symptom disappearance time and operation results were compared between the two groups. The inflammatory factors included serum C-reactive protein (CRP), interleukin 2 (IL-2), interleukin 6 (IL-6), interleukin-8 (IL-8) levels. Results: There was no significant difference in operative time, intraoperative blood loss, hospitalization time and symptom disappearance time between the two groups (P> 0.05), while the exhaust time of the observation group was significantly shorter than that of the control group (P <0.05) The levels of CRP, IL-2, IL-6 and IL-8 in the observation group were significantly lower than those in the control group (P <0.05). There was no significant difference in operative success rate and tubal patency rate between the two groups (P> 0.05); while the intrauterine pregnancy rate of the observation group was significantly higher than that of the control group, the incidence of adverse reactions was significantly lower than that of the control group Statistically significant (P <0.05). Conclusion: Transvaginal hysteroscopy and laparoscopic surgery for tubal pregnancy are effective, and transvaginal hysteroscopy in suppressing inflammation and improving the rate of intrauterine pregnancy again better and more secure.