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目的探讨腹腔镜输卵管妊娠保守手术改良方案的优点和临床意义。方法选择2012年1月至2013年6月肇庆市端州区妇幼保健院收治的输卵管妊娠行腹腔镜保守手术治疗的患者60例,其中36例采用改良方案为研究组,24例采用传统的保守手术为对照组。对两组术中出血量等指标进行分析。结果两组术中出血量、手术时间、持续性异位妊娠率有显著性差异(P<0.05)。两组患者术前β-人绒毛膜促性腺激素(human chorionic gonado-trophin,HCG)水平比较差异无统计学意义(P>0.05),术后第1天和第3天血β-HCG下降率及其降至正常水平的时间比较差异均有统计学意义(P<0.05)。两组术后患侧输卵管通畅度比较差异无统计学意义(P>0.05)。研究组患者患侧和对侧卵巢动脉收缩期最大血流速度、舒张末期最小血流速度,阻力指数的差异比较均无统计学意义(P>0.05)。结论腹腔镜输卵管妊娠保守手术改良方案优于传统的保守手术,可为术后输卵管功能的恢复提供新的依据和参考。
Objective To investigate the advantages and clinical significance of conservative surgery in laparoscopic tubal pregnancy. Methods From January 2012 to June 2013, 60 cases of tubal pregnancy underwent laparoscopic conservative surgery in Duanzhou District Maternal and Child Health Hospital of Zhaoqing were selected. Among them, 36 cases were treated with modified protocol and 24 cases were conservative Surgery for the control group. The two groups of bleeding and other indicators were analyzed. Results The blood loss, operation time and persistent ectopic pregnancy rate in two groups were significantly different (P <0.05). There were no significant differences in preoperative β-human chorionic gonadotrophin (HCG) levels between the two groups (P> 0.05), and the decrease of β-HCG in the first day and the third day after operation And its time to normal levels were statistically significant differences (P <0.05). There was no significant difference in tubal patency between the two groups (P> 0.05). There were no significant differences in the maximum systolic velocity, the minimum diastolic velocity, and the resistance index between the ipsilateral and contralateral ovarian arteries in the study group (P> 0.05). Conclusion Laparoscopic conservative treatment of tubal pregnancy is better than traditional conservative surgery and may provide new evidence for the recovery of tubal function after operation.