保守性手术治疗输卵管妊娠疗效及对生育的影响  

The effect of conservative surgery for tubal pregnancy and the influence of fertility prognosis

作　　者：胡珊[1] 李力[1] 郑英如[1] 郭建新[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所妇产科,重庆400042

出　　处：《重庆医学》2004年第11期1701-1702,共2页Chongqing medicine

摘　　要：目的　探讨保守性手术治疗输卵管妊娠的疗效及对生育的影响。方法　 91例临床确诊的输卵管妊娠患者分为两组 ,保守性手术组 (治疗组 ) 4 5例 ,输卵管壶腹部妊娠行开窗取胚术 35例 ,输卵管峡部妊娠行节段切除吻合术 5例 ,输卵管伞端妊娠行挤出术 3例 ,输卵管间质部妊娠行宫角植入术 2例 ;传统性手术组 (对照组 ) 4 6例 ,采用传统输卵管切除术。结果　两组均成功完成手术 ,均无并发症及持续性异位妊娠发生 ,术后 3d血 β HCG显著下降 ,术后 2周降至正常。治疗组 36例术后 1年行子宫输卵管碘油造影 ,患侧输卵管通畅 30例 ,占 83.3% ,随访 3年 ,治疗组宫内妊娠率为 77.8% (35 / 4 5 ) ,对照组为 4 7.8% (2 2 / 4 6 ) ,两组有显著性差异 (P <0 .0 1)。结论　保守性手术治疗输卵管妊娠安全可靠 ,并发症少 ,是保留育龄妇女生育功能的较好方法。Objective To investigate the effect of conservative surgery for tubal pregnancy and to analyze the fertility prognosis. Methods Ninety-one cases of clinical confirmed tubal pregnancy were divided into two groups, 45 patients undergone conservative surgery (treatment group) and 46 undergone tubal resection (control group). In treatment group, 35 cases of ampullary tubal ectopic pregnancy were performed by linear salpingostomy, 5 cases of isthmic tubal pregnancy were performed by tubal anastomosis, 3 cases of fimbrial tubal pregnancy were performed by embryo extrusion, 2 cases of interstitial pregnancy were performed by uterotubal implantation. Results Tubal pregnancy was treated successfully by both kinds of operations. No complications and persistent ectopic pregnancy occurred. Serum β-HCG significantly falled on postoperative day 3, and to normal level on 14d after operation. The patients were followed up in the 1st year after operation based on the hysterosalpingography. The patent rate of the affected tube in the treatment group was 83.3% (30/36) in the 1st year. The rate of intrauterine pregnancy of treatment group was 77.8%(35/45), and control was 47.8%(22/46). There was a significant difference between the two groups (P<0.01). Conclusions Conservative surgery for tubal pregnancy is a safe, effective, and reliable treatment to reserve the fertility.

关 键 词：输卵管妊娠 保守性手术 生育 治疗 

分 类 号：R713[医药卫生—妇产科学]