腹腔镜手术治疗输卵管憩室合并子宫内膜异位症患者的妊娠结局分析  

Analysis of the pregnancy outcome of laparoscopic surgery for tubal diverticula with endometriosis

作　　者：王艳槟[1] 张秋香[1] 韩红敬[1] 关菁[1] 

机构地区：[1]北京大学人民医院计划生育与生殖科,100044

出　　处：《中国妇产科临床杂志》2015年第4期297-300,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的探讨输卵管憩室与子宫内膜异位症（内异症）的关系及其治疗的效果。方法回顾性分析2010年1月至2014年1月腹腔镜手术治疗的53例输卵管憩室患者的临床资料。术后随访12~18个月,统计妊娠率、流产率及持续妊娠率。结果 53例患者中,经腹腔镜诊断为内异症者84.9%（45/53）,非内异症患者15.1%（8/53）;术中荷包缝合输卵管憩室,同时去除盆腔内异症病灶及其他输卵管异常,术后自然妊娠率为83.0%（44/53）,自然流产率为3.8%（2/53）。其中91.1%（41/45）合并内异症患者术后给予促性腺激素释放激素激动剂（GnRH-a）治疗。GnRHa治疗者术后一年内自然妊娠率为90.2%（37/41）。4例未经GnRH-a治疗的内异症患者术后自然妊娠1例,8例无内异症患者,术后自然妊娠率6例。结论输卵管憩室可能与内异症和不孕症有关。经腹腔镜治疗及对合并内异症患者术后辅助GnRH-a治疗有利于提高妊娠率。Objective Tubal diverticula is a rare disease and has been reported only several times.Our aim is to investigate the clinical characters,diagnosis and treatment for tubal diverticula.Methods Retrospective analysis was conducted on 53 tubal diverticula patients undergoing laparoscopic surgery in Peking University People＇s Hospital from January2010 to January 2014.Results A total of 45（84.9%）out of 53 patients with diverticula had endometriosis,and 41 cases receive the treatment of the GnRH-a.The surgical method was adopted：close diverticula by means of pouch suture.The endometriosis lesion and other diseases of the tubal found during the surgery was also removed.One to six doses of GnRHa were given postoperatively to prevent the recurrence of endometriosis.The pregnancy rate of patients with tubal diverticula was 83.0%（44/53）,and the spontaneous abortion rate was 3.8%（2/53）.Conclusions Tubal diverticula may have a close relationship with endometriosis and infertility.Laparoscopic treatment of diverticular and the use of GnRH-a for endometriosis patients can improve the pregnancy rate.

关 键 词：输卵管憩室 腹腔镜 子宫内膜异位症 不孕症 

分 类 号：R711.6[医药卫生—妇产科学]