输卵管妊娠部位切除后端端吻合术治疗输卵管妊娠的疗效观察  

Therapeutic effect of end-end anastomosis after laparoscopic endoscopic resection of tubal pregnancy

作　　者：杜娟 DU Juan(Department of Gynecology,Xi′an North Hospital,Xi′an,Shaanxi 710043,China)

机构地区：[1]陕西省西安市北方医院妇科,陕西西安710043

出　　处：《检验医学与临床》2020年第8期1087-1089,共3页Laboratory Medicine and Clinic

摘　　要：目的比较腹腔镜下输卵管妊娠部位切除后端端吻合术与腹腔镜下输卵管妊娠部位开窗取胚术后输卵管的通畅情况,观察输卵管妊娠部位切除后端端吻合术的疗效。方法选取2015年3月至2016年6月该院收治的90例输卵管妊娠患者作为研究对象,分为对照组和观察组,每组各45例,对照组采用开窗取胚术,观察组采用端端吻合术。比较两组患者手术相关指标,术后随访3个月,统计比较输卵管通畅情况;随访3年,统计比较两组患者发生持续性异位妊娠、再次输卵管妊娠、宫内妊娠及继发不孕的情况。结果观察组患者术中出血量,手术总时间,术后首次肠胃功能恢复时间均低于对照组,术后3、7 d血人绒毛膜促性腺激素下降率均明显高于对照组,差异均有统计学意义(P<0.05);观察组患者手术后情况正常,对照组患者发生持续性异位妊娠;对照组患者再次输卵管妊娠率明显高于观察组,差异有统计学意义(P<0.05);观察组患者宫内妊娠率高于对照组,差异有统计学意义(P<0.05);两组患者继发不孕发生率比较,差异无统计学意义(P>0.05)。结论腹腔镜指导下输卵管妊娠部位切除后端端吻合术和输卵管妊娠部位开窗取胚术均可作为输卵管妊娠患者的有效治疗方法,但端端吻合术出血少、恢复快,可有效提高输卵管的通畅率,避免发生再次异位妊娠,可在临床推广应用。Objective To compare the patency of the fallopian tube after end-end anastomosis after laparoscopic endoscopic resection of tubal pregnancy and laparoscopic fenestration and embryo-taken surgery,and to observe the curative effect of end-end anastomosis after laparoscopic endoscopic resection of tubal pregnancy.Methods A total of 90 patients with tubal pregnancy admitted to the hospital from March 2015 to June 2016 were selected as the research objects and divided into the control group and the observation group,45 cases in each group.The control group was treated with fenestration and the observation group with end-to-end anastomosis.Surgical related indicators of two groups were compared,and after 3 months follow-up,the patency of fallopian tube was statistically compared.After 3 years of follow-up,patients with persistent ectopic pregnancy,second tubal pregnancy,intrauterine pregnancy and secondary infertility in two groups were compared.Results The intraoperative blood loss in the observation group was less than that in the control group,the total operation time and the first time of gastrointestinal function recovery after operation were all shorter than those in the control group,and blood human chorionic gonadotropin(β-HCG)decline rate on 3 d and 7 d after the operation in the observation group was significantly higher than that in the control group,and the differences were statistically significant(P<0.05).After the operation,the condition in the observation group was normal and the patients in the control group developed persistent ectopic pregnancy.The re-tubal pregnancy rate in the control group was significantly higher than that in the observation group,and the difference was statistically significant(P<0.05).The intrauterine pregnancy rate in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).There was no statistical difference in the incidence of secondary infertility between the two groups(P>0.05).Conclusion End-end anastomosis a

关 键 词：输卵管妊娠 端端吻合术 开窗取胚术 宫内妊娠 腹腔镜 

分 类 号：R714.22[医药卫生—妇产科学]