目的 探讨经阴道宫腔镜治疗输卵管妊娠的临床疗效.方法 将68例输卵管妊娠患者按不同的手术方法 分为研究组36例和对照组32例.研究组行经阴道宫腔镜手术;对照组行腹腔镜手术.观察2组患者术中出血量和手术时间及术后病率、疼痛、排气时间及住院时间、住院费用等情况.监测2组患者血人绒毛膜促性腺激素(HCG)下降及研究组术后1个月检查阴道切口愈合等情况.结果 2组患者手术均顺利,无一例中转开腹.研究组患者行患侧输卵管部分切除术26例,保守手术10例;对照组患者行患侧输卵管部分切除术22例,保守手术10例.研究组患者术后疼痛(0-Ⅰ级)、术后排气时间、术后病率、住院费用与对照组比较差异均有统计学意义(均P＜0.05),研究组患者手术时间、术中出血量、住院时间与对照组比较差异均无统计学意义(均P＞0.05).结论 经阴道宫腔镜治疗输卵管妊娠有较好的疗效,且符合微创要求、安全性更高,是一种治疗异位妊娠较理想的手术方式.%Objective To explore the curative effect of transvaginal hysteroscopic surgery on tubal pregnancy. Methods A total of 68 patients with tubal pregnancy were assigned to receive either transvaginal hysteroscopic surgery (study group, n = 36) or laparoscopic surgery (control group,n= 32). Intraoperative blood loss, operative time, postoperative morbidity, pain, anal exhaust time, length of hospital stay, hospital costs and decrease in blood HCG levels were recorded in both groups. In addition,vaginal surgical wound healing was observed in study group 1 month after operation. Results All patients successfully underwent operation and no cases were converted to open surgery. In study group, partial resection of ipsilateral tubal was performed in 26 patients and conservative surgery in 10. In control group, partial resection of ipsilateral tubal was performed in 22 patients and conservative surgery in 10. There were significant differences in postoperative pain (0- I grade) ,anal exhaust time,postoperative morbidity and hospital costs between the two groups (P0. 05). Conclusion Transvaginal hysteroscopic surgery is effective, safe and minimally invasive for heterotopic pregnancy.
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