腹腔镜下输卵管部分切除联合端端吻合术治疗再次输卵管妊娠的临床效果  

Clinical effect of Laparoscopic partial resection of the fallopian tube and end-to-end anastomosis for the treatment of recurrent tubal pregnancy

作　　者：蒋小兰[1] 康佳丽[1] 张晓燕[1] 唐蔚[1] 陈燕妹[1] 龚艳媚 JIANG Xiao-lan;KANG Jia-li;ZHANG Xiao-yan;TANG Wei;CHEN Yan-mei;GONG Yan-mei(Department of Gynecology and Obstetrics,Guangzhou First People′s Hospital,Guangdong Province,Guangzhou 511457,China;Department of Ultrasound,Guangzhou First People′s Hospital,Guangdong Province,Guangzhou 511457,China)

机构地区：[1]广州市第一人民医院妇产科,广东广州511457 [2]广州市第一人民医院超声科,广东广州511457

出　　处：《中国当代医药》2020年第18期110-113,共4页China Modern Medicine

基　　金：广东省广州市医药卫生科技项目(20161A010012)。

摘　　要：目的 研究腹腔镜下输卵管部分切除及端端吻合术治疗再次输卵管妊娠的疗效及妊娠结局.方法 选取2014年1月~2018年12月我院收治的60例再次输卵管壶腹部或峡部妊娠患者作为研究对象,根据随机分组原则分为观察组与对照组,每组各30例.观察组采用腹腔镜下输卵管部分切除及端端吻合术治疗,对照组采用腹腔镜下输卵管妊娠物清除术(包括开窗术及切开取胚缝合术).比较两组手术时间、术中出血量、术后住院时间,术后血绒毛膜促性腺激素(HCG)下降情况、持续性异位妊娠的发生率,术后患侧输卵管通畅情况(子宫输卵管造影)及术后再次宫内妊娠率.结果 观察组手术时间为(74.5±5.3)d,长于对照组的(53.5±4.7)d,差异有统计学意义(P<0.05);观察组术中出血量为(25.6±5.2)ml及术后住院时间为(4.0±2.9)d,与对照组的(30.1±4.8)ml、(4.0±3.7)d比较,差异无统计学意义(P>0.05);观察组术后3d和术后2周的血HCG下降为(82.5±5.4)、(91.2±2.7) mIU/ml,高于对照组的(65.5±4.8)、(98.4±1.6) mIU/ml,差异有统计学意义(P<0.05);观察组持续性异位妊娠的发生率(0.00%)低于对照组(10.00)%,差异有统计学意义(P<0.05);观察组输卵管通畅情况优于对照组,术后再次宫内妊娠率高于对照组,差异有统计学意义(P<0.05).结论 腹腔镜下行输卵管部分切除及端端吻合术治疗再次输卵管妊娠,可降低持续性异位妊娠发生,提高术后再次宫内妊娠率,而降低因辅助生殖对患者身体造成伤害及减轻患者经济负担.Objective To study the efficacy and pregnancy outcome of laparoscopic partial fallopianectomy and end-to-end anastomosis for recurrent tubal pregnancy.Methods A total of 60 patients with ampulla or isthmus pregnancy who were admitted to our hospital from January 2014 to December 2018 were selected as the research objects.They were divided into observation group and control group according to the principle of random grouping.The observation group was treated with laparoscopic partial salpingectomy and end-to-end anastomosis,and the control group was treated with laparoscopic tubal pregnancy removal(including fenestration and incision embryo suture).Surgical time,intraoperative blood loss,postoperative hospitalization time,postoperative decrease in human choionic gonadotophin(HCG),incidence of persistent ectopic pregnancy,and incidence of tubal on the affected side Unobstructed condition(uterine fallopian tube angiography)and postoperative intrauterine pregnancy rate were compared between two groups.Results The operation time was(74.5±5.3)d in the observation group,longer than that in the control group for(53.5±4.7)d,and the difference was statistically significant(P<0.05);the intraoperative blood loss was(25.6±5.2)ml and postoperative hospital stay was(4.0±2.9)d in the observation group,compared with the control group for(30.1±4.8)ml,(4.0±3.7)d,the differences were not statistically significant(P>0.05);the blood HCG in patients in the observation group decreased 3 d and 2 weeks after surgery was(82.5±5.4),(91.2±2.7)mIU/ml,which was higher than that in the control group for(65.5±4.8),(98.4±1.6)mIU/ml,the differences were statistically significant(P<0.05);the incidence of persistent ectopic pregnancy in the observation group was(0.00%)lower than that of the control group(10.00%),the difference was statistically significant(P<0.05).The tubal patency of the observation group was better than that of the control group,and the rate of intrauterine pregnancy again was higher than that of the control group,the di

关 键 词：腹腔镜 输卵管部分切除及端端吻合术 再次输卵管妊娠 持续性异位妊娠 效果 

分 类 号：R713[医药卫生—妇产科学]