compared with laparotomy up to July 2009.Data were evaluated and extracted by two reviewers independently with designed extraction form.The Cochrane Collaboration’s RevMan 5.0.1 software was used for data analyses.Results 12 studies(involving 1 193 patients)were included.Meta analysis showed that laparoscopy compared with laparotomy，the normal pregnancy rate and second ectopic pregnancy rate in one year had no difference，barren rate in one year and three years have no difference，but the three years’normal pregnancy rate of laparoscopy was higher than laparotomy，the three years’ second ectopic pregnancy rate was lower than laparotomy.Conclusion Uses laparoscopy and laparotomy treating for ectopic pregnancy，the fertility outcome has no difference in a short period，but in the long run，laparotomy is better to ectopic pregnancy patients for their normal pregnancy after surgery.
[Key words] ectopic pregnancy;laparoscopy;laparotomy;fertility outcome;Meta analysis
异位妊娠是妇科常见疾病，其发病率有逐年上升的趋势[1]。治疗异位妊娠常用的方法是开腹和腹腔镜手术，但对于应用开腹手术较腹腔镜手术更有利于保护患者的生育功能，邵军晖等[2]和Darwish等[3]报道，腹腔镜手术与开腹手术治疗异位妊娠术后输卵管复通率和宫内妊娠率差异显著，认为腹腔镜手术具有术后输卵管复通率、宫内妊娠率高的优点，值得推广应用。而Saleh等[4]在对输卵管妊娠行腹腔镜和开腹手术治疗后生育状态的研究中发现，腹腔镜手术组宫内妊娠率74.0%，而开腹手术组为61.0%，而重复性异位妊娠在腹腔镜治疗组为4.0%，在开腹手术组为10.0%，两者之间差异无统计学差异。同样，Lundorff等[5]的研究也发现腹腔镜手术与开腹手术治疗异位妊娠后的生育结局没有差异。腹腔镜手术与开腹手术治疗异位妊娠后的生育结局到底有无差异，本研究将国内外的腹腔镜手术和开腹手术对比治疗异位妊娠的对照试验进行Meta分析，评价两种不同手术方式治疗异位妊娠后患者的生育结局，为尚未生育的异位妊娠患者合理选择手术方式提供一定的循证医学证据。
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