薄壁及厚壁输卵管积水整形术后妊娠结局和复发情况比较研究  

Comparison of the pregnancy outcome and recurrence between thin and thick wall hydrosalpinx after anaplasty

作　　者：于晓明[1] 关菁[1] 韩红敬[1] 沈浣[1] 蔺会兰[2] 

机构地区：[1]北京大学人民医院妇产科,北京100044 [2]石家庄市第一医院,河北石家庄050000

出　　处：《中国实用妇科与产科杂志》2016年第1期90-93,共4页Chinese Journal of Practical Gynecology and Obstetrics

摘　　要：目的探讨薄壁及厚壁输卵管积水患者在腹腔镜下行新型输卵管整形术后妊娠结局及复发情况的差异。方法严格按照入组标准，选择北京大学人民医院2003年1月至2009年11月因输卵管积水腹腔镜下行新型整形术的不孕患者201例，依据Brosens，Ivo方法将患者分为薄壁输卵管积水组123例和厚壁组78例，观察术后两组间妊娠结局及输卵管积水复发情况的差异。结果两组间患者年龄比较差异无统计学意义俨〉0．05）；术后薄壁组总妊娠率、自然妊娠率、体外受精（IVF）妊娠率分别为47．97％、47．32％、54．55％，均高于厚壁组17．95％、16．98％、20．00％，两组间比较差异有统计学意义（P〈0．05）。其中自然妊娠中宫内妊娠率两组间比较差异有统计学意义俨〈0．05），薄壁组为37．50％高于厚壁组7．55％；异位妊娠率比较差异无统计学意义俨〉0．05），术后7～8个月自然妊娠率最高。薄壁积水合并盆腔粘连发生率（72．36％）低于厚壁积水组（96．15％），两组间比较差异有统计学意义（P〈0．05）；复发率两组间比较差异有统计学意义（P〈0．05），薄壁组（6．50％）明显低于厚壁组（21．79％）。结论薄壁输卵管积水患者整形术后的妊娠率明显优于厚壁积水患者。在临床治疗中对输卵管积水进行分类，对薄壁输卵管积水患者腹腔镜下行输卵管整形术术后可得到较满意的妊娠结局，而对于厚壁输卵管积水患者行整形术后妊娠结局较差，建议酌情行输卵管近端结扎或切除术。Objective To study the difference of pregnancy outcome and recurrence after treatment for thin and thick wall hydrosalpinx in patients undergoing laparoscopic anaplasty. Methods In strict accordance with the standards, 201 were chosen infertility patients , who received the tubal anaplasty under laparoscope because of hydrosalpinx. According to Brosens, Ivo method, divide the patients into thin wall hydrosalpinx group （123） and thick wall group （78）;observe the postoperative pregnancy outcome and recurrence between the two groups. Results The patients＂ average age between the two groups had no statistical difference （P〉O.05）. In thin wall group, the total pregnancy rate, the natural pregnancy rate and the pregnancy rate of IVF were 47.97%, 47.32% and 54.55%, which were higher than those in thick wall group （17.95%, 16.98% and 20.O0%）,the differences between the two groups being statistically significant （P〈0.05）.In the natural pregnancy, the intrauterine pregnancy rate between the two groups had statistically significant difference （P〈 0.05）, in the thin wall it was 37.50%, higher than that of thick wall group （7.55%）. Ectopic pregnancy rate had no statistical difference （/）〉0.05）. The natural pregnancy rate was the highest in 7-8 months after surgery. In thin wall group rate of pelvic adhesion （72.36%） was lower than that in the thick wall group （96.15%）, and the differences between the two groups was statistically significant （P〈0.05）. Recurrence rates between the two groups had statistically significant difference （P〈0.05）, the thin-walled group （6.50%） was lower than thick wall group （21.79%）. Conclusion After anaplasty, the pregnancy rate of patients with thin wall hydrosalpinx is obviously better than that of patients with thick wall hydrosalpinx. With classification of hydrosalpinx in clinical treatment, patients with thin wall hydrosalpinx can get satisfactory pregnancy outcomes after anaplasty under laparoscope. However, those with t

关 键 词：输卵管积水 薄壁 厚壁 输卵管整形术 

分 类 号：R711.76[医药卫生—妇产科学]