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[目的]探讨提高输卵管妊娠腹腔镜保守性手术成功率的方法。[方法]65例诊断为输卵管妊娠的患者随机分为观察组(33例)和对照组(32例),观察组病例经MTX化疗后行腹腔镜开窗取胚术,对照组病例直接行腹腔镜开窗取胚术,比较两组术中出血、手术时间、输卵管保留率、持续性宫外孕发生率、肝肾功能等方面的差异。[结果]观察组和对照组术中出血量分别为(38.26±16.02)ml、(83.13±28.15)ml,手术时间分别为(24.16±8.09)min、(45.08±17.32)min,输卵管保留率分别为100%(33/33)、75.00%(24/32),持续性宫外孕发生率分别为0.00%(0/33)、20.83%(5/24),差异均有统计学意义(P﹤0.05);两组肝肾功能差异无统计学意义(P﹥0.05)。[结论]术前MTX化疗能减少输卵管妊娠腹腔镜保守性手术中出血量、缩短手术时间,提高输卵管成功保留率。
[Objective] To explore the method to improve the success rate of laparoscopic conservative surgery in tubal pregnancy. [Method] Sixty-five patients with tubal pregnancy were randomly divided into observation group (33 cases) and control group (32 cases). The patients in observation group underwent laparoscopic window-embryo implantation after MTX chemotherapy. The control group received abdominal cavity Mirror open window to take embryo surgery, compared two groups of intraoperative bleeding, operation time, tubal retention rate, the incidence of persistent ectopic pregnancy, liver and kidney function differences. [Results] The blood loss in observation group and control group were (38.26 ± 16.02) ml and (83.13 ± 28.15) ml respectively, and the operation time was (24.16 ± 8.09) min and (45.08 ± 17.32) min respectively. The tubal retention rates were The incidence of persistent ectopic pregnancy was 0.00% (0/33) and 20.83% (5/24) respectively, with statistical significance (P <0.05) ); There was no significant difference between the two groups in liver and kidney function (P> 0.05). [Conclusion] Preoperative MTX chemotherapy can reduce the amount of bleeding during laparoscopic conservative surgery for tubal pregnancy, shorten the operation time and improve the success rate of tubal retention.