宫外孕的保守手术治疗 Conservative surgical treatment of ectopic pregnancy

陈凤林教授指出：宫外孕保守手术就是保留输卵管，取出胚胎，适合有生育要求者;根治手术就是切除患侧输卵管，适合无生育要求和抢救生命者;

Professor Chen Fenglin pointed out that the conservative operation of ectopic pregnancy is to retain the fallopian tube and take out the embryo, which is suitable for those who have fertility requirements; the radical operation is to remove the affected fallopian tube, which is suitable for those who have no fertility requirements and save lives;

安太特色治疗：Antai characteristic treatment:

1、腹腔镜下开窗取胚术：对于输卵管未破裂或输卵管破口不大的宫外孕，通过腹腔镜，保留输卵管，不开腹，在治疗的同时查找病因：如有盆腔粘连，松解粘连+放置防粘膜，如有子宫纵隔，分离纵隔+宫腔支架或输卵管支架;对孕囊破裂内失血多或休克者，尽量要通过血液回收机，回输自体血液。避免用外源血防范传染病。紧急情况者例外。

1. Laparoscopic fenestration: For ectopic pregnancy without rupture of fallopian tube or small rupture of fallopian tube, through laparoscopy, retain the fallopian tube, open the abdomen, and find out the cause of the disease at the same time of treatment: if there is pelvic adhesions, release the adhesions + place the anti-mucosa, if there is a uterine septum, separate the mediastinum + uterine cavity stent or fallopian tube stent; for those who have more bleeding or shock in the rupture of the gestational sac, try to pass through. Autologous blood is transfused back through the blood recovery machine. Avoid using exogenous blood to prevent infectious diseases. Exceptions are made in emergencies.

2，宫外孕宫内手术术：适用于多次宫外孕无孩子，胎囊无破裂者，采取宫腹腔镜下输卵管卵巢开窗取胚+输卵管成形术，对于要求继续妊娠的患者开展胚胎宫外转移到宫内术式。目的是保留器官完整、保留生育能力，并通过宫腹腔镜找出此次宫外孕的原因，以避免再重导复辙!腹腔镜下取胚，手术到宫腔，经B超和HCG监测继续妊娠。

2. Intrauterine transplantation of ectopic pregnancy: for multiple ectopic pregnancies without children and rupture of the fetal sac, hysteroscopy and laparoscopic oviduct ovary fenestration plus salpingoplasty are adopted. For those who require continued pregnancy, extrauterine transfer of embryos to the uterus is carried out. The purpose is to preserve organ integrity and fertility, and to find out the cause of ectopic pregnancy through hysteroscopy and laparoscopy, so as to avoid reoccurrence. Embryos were taken under laparoscopy and transplanted into uterine cavity, and pregnancy was continued by B-mode ultrasound and HCG monitoring.

超微创单孔腹腔镜手术：适用于未婚未生育者，优点是腹壁无瘢痕，不留任何蛛丝马迹;最大限度的保护了患者的隐私。

Ultra-minimally invasive single-port laparoscopic surgery: for unmarried and infertile people, the advantage is that there is no scar on the abdominal wall, leaving no trace; to maximize the protection of patients'privacy.