腹腔镜早期诊断和治疗异位妊娠的临床意义.doc

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1、腹腔镜H期诊断和治疗异位妊娠的临床意义【关键词】不孕【摘耍】目的评估异位妊娠(Ectopicpregenacy,EP)患者行腹腔镜(laparoscopy,LSC)早期诊断和急诊手术的临床价值。方法冋顾性分析1999年1月〜2003年10月收治的经腹腔镜手术治疗的可疑EP患者162例，均在入院后接受LSC手术。结果⑹例手术经腹腔镜完成，1例屮转开腹，均无并发症发生。术中诊断154例(均经病理证实)，术前诊断符合率95.06%;其余病例依次为卵巢囊肿4例，宫内妊娠黄体破裂4例。27例合并不孕患者，27例有盆腔粘

2、连，15例有输卵管病变，均行相应处理。7例少见EP,10例休克型EP,经腹腔镜于-术效果满意。结论急诊腹腔镜手术不仅可早期确诊早期可疑EP患者，为保守治疗赢得时间，同时述可对不孕症患者进行治疗。急诊LSCf-术可用来治疗休克型和少见部位EP。关键词异位妊娠腹腔镜手术不孕vPstyle='TEXT-INDENT:24pxMalign=center>Clinicalsignificanceofearlydiagnosisandtreatm

3、entofectopicpregnancybylaparoscopyShenWeihong,KeYuDepartmentofObstericsandGynecology,GongLiHospitalPudongNewArea,Shanghai200135・[Abstract]ObjectiveToevaluatetheclinicalvalueofearl

4、ydiagnosisandemergencyoperationofsuspiciousectopicpregnancy(EP)byLaparoscopy.MethodsTheclinicaldateofl62suspiciousEPpatientswhohadreceivedemergencylaparoscopicoperationinourhospitalduringJanuary1999toOctober2003werereceived.Allcasesre一ceivedemergencylaparos

5、copicoperationwithinadmission.ResultsTheoperationwasperfonnedon162casesbyLSCwithoutcomplications,onlyonecasewastransferredtotraditionalsurgeryduringtheoperation.EPwasdiagnosedinl54casesduringoperation(withpathogicproof),thecoincidenceratewithpreoprationaldi

6、agnosisbeing95.06%,othercaseswere:4casesofovariancyst,4casesintrauterinepregnancycomplicatedwithlutealrupture.Of27patientsinfertility,27caseshadpelvicadhensionandl5caseshadtubeletionsandreceivdpropertreatment.In7caseswithrarelyseenEP(including4interstitialp

7、regnancy,3overianpregnancy)andlOcaseswithEPcomlicatedhypovolemicshock,theLSCoperationwasalsoeftective.ConclusionTheLSCoperationcanearlydiagnoseEPtogaintimeforconservativetherapy,anditcanalsodiagnoseandtreatinferti1ity.Emergencylapsrscopicoperationisusedtotr

8、eatEPwithhypovolemicshockandrare・Keywordsectopicpregnancyoperativelaparoscopyinfertility异位妊娠(EP)是妇产科常见急腹症，也是孕产妇死亡的主要原因之一。山于婚前性行为及人流率的上升，使得异位妊娠的发病率也呈不断上升趋势。随看腹腔镜手术在妇科领域的广泛应用，腹腔镜诊断和治疗异位妊娠的价值越来越大，本研究旨在评价腹