腹腔镜保守手术对输卵管妊娠并存输卵管病变患者术后生育能力的影响  

Clinical analysis of the reproductive performance and its related influential factors after laparoscopic oviduct-sparing surgical treatment of tubal pregnancy with tubal disease

作　　者：符爱珍[1] 张颖[1] 廖靖[1] 

机构地区：[1]广东湛江广东医学院附属医院妇产科,524001

出　　处：《中国现代医药杂志》2013年第2期23-27,共5页Modern Medicine Journal of China

摘　　要：目的探讨腹腔镜保守性手术治疗对输卵管妊娠并存输卵管病变患者术后生育状况的影响,寻找提高术后宫内妊娠率的方法。方法对208例有生育要求的输卵管妊娠并存输卵管病变患者(研究组)经腹腔镜保守性手术治疗,与同期行患侧输卵管切除的78例并存输卵管病变患者(对照组)进行比较分析,观察术后输卵管通畅程度、宫内妊娠率情况。结果随访2年,研究组术后宫内妊娠106例(50.96%),对照组18例(23.08%)。两组术后宫内妊娠率比较差异有显著性(P<0.01)。既往盆腔炎、术前血HCG水平、异位妊娠史、既往输卵管手术史、患侧及对侧输卵管不通是影响术后宫内妊娠率的影响因素。结论腹腔镜保守性手术治疗输卵管妊娠并存输卵管病变微创、安全,术后宫内妊娠率高,预防盆腔炎症,术中积极处理盆腔粘连及输卵管病变,是提高患者术后宫内妊娠率的重要手段。Objective To investigate the reproductive performance and its related influential factors after laparoscopic oviduct-sparing surgical treatment of tubal pregnancy with tubal disease.Try to find the way to improve the rate of intrauterine pregnancy.Methods The rate of post-operative oviduct patency and intrauterine pregnancy were selected to compare two groups on treating tubal pregnancy with tubal disease through laparoscopic surgical treatment：laparoscopic oviduct-sparing operation group（investigating group with 208 cases） and laparoscopic salpingectomy group（contrasting group with 78 cases）.Results Follow-up two years,the rate of intrauterine pregnancy was significantly different between investigating group and contrasting group（P0.01）：Investigating group was 50.96%（106 cases） and contrasting group was 23.08%（18 cases）,respectively.Multi-factors analysis showed that the reproductive performance was related to the pelvic inflammation,pre-operative serum level of HCG,the history of ectopic pregnancy,pre-operation of the tubal and the post-operative block of the contra-lateral oviduct and the affected oviduct.Conclusion Laparoscopic oviduct-sparing operation in treatment of tubal pregnancy is safe and mini-invasive,and has advantage of higher intrauterine pregnancy.Preventing pelvic inflammation,treating positively on the pelvic adhesion and tubal diseases,it is the important measure to improve the rate of intrauterine pregnancy after laparoscopic oviduct-sparing surgical treatment of tubal pregnancy with tubal disease.

关 键 词：输卵管妊娠 输卵管病变 腹腔镜手术 保守性手术 生殖状况 

分 类 号：R713[医药卫生—妇产科学]