腹腔镜下输卵管开窗术与输卵管切除术对输卵管妊娠患者生育结局的影响  

Effects of laparoscopic salpingectomy and salpingectomy on the fertility outcome of tubal pregnancy

作　　者：邓笑容 邬朝晖 黄洪萍 DENG Xiaorong;WU Chaohui;HUANG Hongping(Zhongxin Huizhou Hospital,Huizhou 516006, China)

机构地区：[1]中信惠州医院,广东惠州516006

出　　处：《包头医学院学报》2020年第4期15-16,45,共3页Journal of Baotou Medical College

基　　金：惠州市科技计划项目(180614151740426)。

摘　　要：目的:分析腹腔镜下输卵管开窗术与输卵管切除术对输卵管妊娠患者生育结局的影响。方法:选取2015年2月至2017年12月收治的130例输卵管妊娠患者,随机分为输卵管开窗术组和切除术组两组;开窗术组患者进行腹腔镜下输卵管开窗术治疗,切除术组患者进行腹腔镜下输卵管切除术治疗;比较两组患者的手术指标、术后并发症发生情况、术后随访2年内妊娠情况、术后3个月输卵管通畅情况。结果:开窗术组患者的手术时间(20.48±2.62)min,较切除术组患者的(32.76±2.59)min缩短;开窗术组患者的术中出血量(45.22±5.73)mL,较切除术组患者的(61.98±5.64)mL减少(P<0.05);开窗术组和切除术组两组患者的HCG恢复时间分别为(20.01±2.65)d和(19.89±2.43)d,住院时间分别为(6.45±1.27)d、(6.39±1.15)d,组间相比差异无统计学意义(P>0.05);术后两组患者的并发症发生率分别为20.00%和23.08%,差异无统计学意义(P>0.05);术后随访2年内开窗术组患者宫内妊娠率为70.77%,较切除术组患者的35.85%提高(P<0.05);开窗术组患者继发性不孕率为23.08%,较切除术组患者的41.54%降低(P<0.05);两组患者的异位妊娠率分别为6.15%和4.62%,差异无统计学意义(P>0.05);术后3个月开窗术组患侧输卵管通畅率为46.15%、对侧输卵管通畅率为80.08%,切除术组输卵管通畅率为81.54%,差异无统计学意义(P>0.05)。结论:腹腔镜下输卵管开窗术治疗输卵管异位妊娠可缩短手术时间,减少术中出血量,减轻患者创伤,提高宫内妊娠率,建议在临床上推广。Objective:To compare and analyze the effects of laparoscopic salpingotomy and salpingectomy on the fertility outcomes of patients with tubal pregnancy.Methods:130 patients with tubal pregnancy who were admitted from February 2015 to December 2017 were randomly divided into group A and Group B.Group A was treated with laparoscopic salpingectomy,and group B was treated with laparoscopic salpingectomy.Operative indicators,postoperative complications,pregnancy during 2 years of postoperative follow-up and patency of fallopian tubes 3 months after operation were compared in the two groups.Results:The operation time in group A(20.48±2.62)min was significantly shorter than that in group B(32.76±2.59)min,and the intraoperative blood loss(45.22±5.73)ml was significantly higher than that in group B(61.98±5.64).The difference was statistically significant(P<0.05).The recovery time of HCG in the two groups was(20.01±2.65)d,(19.89±2.43)d,and the hospitalization time was(6.45±1.27)d,(6.39±1.15)d,and the difference was not statistically significant(P>0.05).The postoperative complication rates of the two groups were 20.00%and 23.08%,and the difference was not statistically significant(P>0.05).The intrauterine pregnancy rate of the patients in group A within 2 years of postoperative follow-up was 70.77%,which was 35.85%higher than that in group B(P<0.05).The rate of secondary infertility in group A was 23.08%,which was lower than 41.54%in group B(P<0.05).The ectopic pregnancy rates of the two groups were 6.15%and 4.62%,respectively,with no statistically significant difference(P>0.05).Three months after surgery,the patency rate of the affected fallopian tube was 46.15%,the contralateral tubal patency rate was 80.08%,and the tubal patency rate of group B was 81.54%,with no statistically significant difference(P>0.05).Conclusion:Laparoscopic tubal fenestration treatment of tubal ectopic pregnancy can significantly shorten the operation time,reduce the amount of intraoperative bleeding,reduce the trauma of the patient,increas

关 键 词：腹腔镜 输卵管开窗术 输卵管切除术 输卵管异位妊娠 生育结局 

分 类 号：R71[医药卫生—妇产科学]