门诊宫腔镜对输卵管妊娠术后患者宫内妊娠率的临床疗效  

Clinical Effect of Hysteroscopy on the Rate of Intrauterine Pregnancy in Patients after Tubal Pregnancy Operationunder Laparoscope

作　　者：王超群[1] 牛洁[1] 蒋苹 高俊丽[1] 孟丽燕[1] 刘红梅[1] WANG Chao-qun;NIU Jie;JANG Ping;GAO Jun-li;MENG Li-yan;LIU Hong-mei(The Second Department of Gynecology and Obstetrics,Kunming Maternal and Child Health Hospital,Kunming Yunnan 650032,China)

机构地区：[1]昆明市妇幼保健院妇二科,云南昆明650032

出　　处：《昆明医科大学学报》2020年第7期155-159,共5页Journal of Kunming Medical University

基　　金：昆明市妇幼保健院院内自选课题基金资助项目(2017-19)。

摘　　要：目的观察输卵管妊娠术后患者经门诊宫腔镜检查和治疗后输卵管的通畅情况及宫内妊娠率情况。方法选取既往因输卵管妊娠行腹腔镜下患侧输卵管开窗取胚术患者39例为开窗组,腹腔镜切除患侧输卵管患者35例为切除组,对两组患者术后3月均行门诊宫腔镜检查术,了解输卵管通畅情况,并针对阻塞的输卵管行导丝介入治疗,比较介入后两组的输卵管通畅率,观察宫腔镜术后1 a两组病例的宫内妊娠率。结果(1)开窗组患侧输卵管通畅率为48.72%,健侧输卵管通畅率为58.97%。行导丝介入治疗后,患侧输卵管通畅率为89.74%,健侧输卵管通畅率为94.87%;(2)切除组健侧输卵管通畅率为77.14%,介入治疗后输卵管通畅率为91.43%;(3)在输卵管均通畅的前提下,开窗取胚组宫内妊娠14例,妊娠率40.00%;切除组宫内妊娠11例,妊娠率34.37%;比较两组妊娠率差异无统计学意义(P>0.05)。其中宫腔镜术后半年内开窗取胚组宫内妊娠12例,占开窗组宫内妊娠人数的85.74%;切除组宫内妊娠10例,占切除组宫内妊娠人数的90.91%;比较两组宫内妊娠率,差异无统计学意义(P>0.05)。结论门诊宫腔镜对输卵管妊娠治疗后患者阻塞的输卵管有显著的再通作用,再通后半年能获得较好的宫内妊娠率。在输卵管均通畅的前提下,腹腔镜下输卵管开窗取胚术与输卵管切除术治疗输卵管妊娠患者的宫内妊娠率不存在差异。Objective To observe the patency of fallopian tube and the rate of intrauterine pregnancy after hysteroscopy and treatment.Methods 39 cases of laparoscopic fenestration of fallopian tube due to previous tubal pregnancy were selected as the fenestration group,35 cases of laparoscopic resection of fallopian tube were selected as the resection group.Three months after operation,hysteroscopy was performed in both groups to understand the patency of fallopian tube,and for the obstructed fallopian tube,interventional therapy was performed.The patency rate of fallopian tube was compared between the two groups,and the intrauterine pregnancy rate was observed in one year and two groups after hysteroscopy.Results(1)For the fenestration group,the tubal patency rate was 48.72%;the uninjured fallopian tube patency rate was 58.97%.After interventional treatment with guide wire,the rate of affected fallopian tube was 89.74%,and the rate of uninjured fallopian tube patency was 94.87%.(2)For the resection group,the patency rate of uninjured fallopian tube was 77.14%,and the patency rate of fallopian tube after interventional treatment was 91.43%.(3)On the premise that the fallopian tubes were unobscured,pregnancy rate in the fenestration group was40.00%in 14 cases.Pregnancy rate was 34.37%in 11 cases in the resection group.There was no significant difference in pregnancy rate between the two groups(P>0.05).Among them,12 cases were pregnant in the fenestration group within half a year after hysteroscopic surgery,accounting for 85.74%of pregnancies.There were 10 pregnancies in the fenestration group,accounting for 90.91%of all pregnancies in the resection group.There was no statistically significant difference in pregnancy rates between the two groups(P>0.05).Conclusions Hysteroscopy has significant recanalization effect on the blocked fallopian tubes after tubal pregnancy treatment,and a better repregnancy rate can be obtained half a year after recanalization.Under the condition that the tubal is unobstructed,there is no differenc

关 键 词：门诊宫腔镜 输卵管妊娠 输卵管阻塞 

分 类 号：R711.7[医药卫生—妇产科学]