辅助生育技术后异位妊娠腹腔镜手术48例分析

摘要

Objective To explore the characteristics of laparoscopic surgery for the treatment of ectopic pregnancy following assisted reproductive techniques,and to provide the reference for the trentment of the desease.Methods A clinical data of 48 patients with ectopic pregnancy following assisted reproductive techniques who underwent laparoscopic surgery were retrospectively analyzed .Results Forty-eight cases underwent laparoscopic surgery successfully ,no case conversed to laparotomy,no postoperative complications .Twelve cases (25.0%) underwent salpingotomy ,and 36 cases (75.0%) underwent salpingectomy.There were 48 cases of tubal pregnancy including 8 cases(16.7%) of interstitial tubal pregnancy, 8 cases(16.7%) of isthmus pregnancy,28 cases(58.2%) of ampullary pregnancy,2 cases(4.2%) of umbrella pregnancy, and 2 cases(4.2%) of cornual pregnancy.There were 48 cases of pelvic adhesions,6 cases(12.5%) complicated with ovarian hyperstimulation syndrome .Conclusion The history of pelvic inflammatory disease and history of tubal operations are common factors for ectopic pregnancy following assisted reproductive techniques .Ectopic pregnancy following assisted reproductive techniques particularly presents as a high incidence of interstitial tubal pregnancy ,pelvic adhesions, ovarian hyperstimulation syndrome and heterotopic pregnancy .%目的：探讨行辅助生育技术后异位妊娠腹腔镜手术的特点，为治疗辅助生育技术后异位妊娠提供参考。方法回顾性分析腹腔镜手术治疗辅助生育技术后异位妊娠48例患者的临床资料。结果48例患者均顺利完成腹腔镜手术，无中转开腹，术后无明显并发症。行输卵管保守性手术12例（25．0％），输卵管切除术36例（75．0％）。输卵管妊娠48例，其中间质部妊娠8例（16．7％），峡部妊娠8例（16．7％），壶腹部妊娠28例（58．2％），伞部妊娠2例（4．2％），宫角妊娠2例（4．2％）。48例患者均有不同程度盆腔粘连，合并卵巢过度刺激综合征6例（12．5％）。结论既往盆腔炎病史、输卵管手术史是发生辅助生育技术后异位妊娠的易发因素。输卵管间质部妊娠发生率高，盆腔不同程度粘连，合并卵巢过度刺激综合征，宫内宫外同时妊娠为辅助生育技术后异位妊娠的特殊类型。