输卵管积水患者经宫腔镜输卵管栓堵术与经腹腔镜输卵管结扎术后冻胚移植妊娠结局的比较研究  

Comparison of pregnancy outcomes after frozen embryo transplantation between patients with hydrosalpinx after hysteroscopic tubal embolization and laparoscopic tubal ligation

作　　者：章由生 颜磊 于倩 姚志娜 韩婷 马金龙 ZHANG You-sheng;YAN Lei;YU Qian(Affiliated Reproductive Hospital of Shandong University,Cheeloo College of Medicine,Shandong University,Key Laboratory of Reproductive Endocrinology of Ministry of Education,Shandong Key Laboratory of Reproductive Medicine,Shandong Provincial Clinical Research Center for Reproductive Health,National Research Center for Assisted Reproductive Technology and Reproductive Genetics,Jinan 250012,China)

机构地区：[1]山东大学附属生殖医院,生殖内分泌教育部重点实验室,山东省生殖医学重点实验室,山东省生殖健康临床医学研究中心,国家辅助生殖与优生工程技术研究中心,山东济南250012

出　　处：《腹腔镜外科杂志》2021年第3期227-230,共4页Journal of Laparoscopic Surgery

摘　　要：目的:比较经宫腔镜输卵管栓堵术与经腹腔镜输卵管结扎术在不孕症患者冻胚移植(FET)助孕中的优势,以期为输卵管积水处理的临床选择提供数据支撑。方法:回顾分析2016~2019年因输卵管积水行常规FET治疗的不孕症患者的临床资料,按FET前患者的输卵管积水处理方式分为栓堵组(A组,n=37)与结扎组(B组,n=111)。从手术持续时间、住院费用、手术风险、术后第1次FET妊娠结局等方面,对比两种手术的优势。结果:A组手术时间[(46.5±21.1)min vs.(59.7±21.7)min,t=3.274,P<0.05]短于B组,A组术后移植间隔时间[(6.5±8.2)个月vs.(3.0±2.6)个月,t=2.599,P<0.05]长于B组;A组着床率(51.3%vs.75.4%,P<0.05)、临床妊娠率(48.6%vs.77.5%,P<0.05)、活产率(37.8%vs.69.4%,P<0.05)均低于B组。两组患者在住院总费用、早期流产率、晚期流产率方面差异无统计学意义(P>0.05)。结论:在提高妊娠率方面,腹腔镜输卵管结扎术优于经宫腔镜输卵管栓堵术,但后者仍可作为复杂盆腔环境患者的腹腔镜手术优选替代方案,具有较好的临床推广价值。Objective:To compare the advantages and disadvantages of hysteroscopic tubal occlusion and laparoscopic tubal ligation in the treatment of infertility patients with frozen embryo transfer(FET),aiming to provide data supporting the clinical selection of hydrosalpinx treatment.Methods:The clinical data of infertile hydrosalpinx patients treated by routine FET from 2016 to 2019 were retrospectively analyzed.According to the treatment of hydrosalpinx before FET,patients were divided into suppository group(group A,n=37)and ligation group(group B,n=111).The aspects of operation duration,hospitalization cost,operation risk,the first FET pregnancy outcome after operation were compared for the advantages and disadvantages of the two methods.Results:The operative duration of group A was(46.5±21.1)min,which was significantly shorter than(59.7±21.7)min in group B(t=3.274,P<0.05).The postoperative interval time between transplantation of group A was(6.5±8.2)months,which was significantly longer than(3.0±2.6)months in group B(t=2.599,P<0.05).Implantation rate(51.3%vs.75.4%,P<0.05),clinical pregnancy rate(48.6%vs.77.5%,P<0.05)and live birth rate(37.8%vs.69.4%,P<0.05)of group A were significantly lower than those of group B.There was no statistically significant difference in total hospitalization cost,rate of early abortion and late abortion between the two groups(P>0.05).Conclusions:Laparoscopic tubal ligation is superior to hysteroscopic tubal embolization in improving pregnancy rate,but the latter can still be used as a preferred alternative of laparoscopic surgery in patients with complex pelvic environment,hysteroscopic tubal embolization has a good prospect of clinical application.

关 键 词：输卵管积水 宫腔镜检查 腹腔镜检查 冻胚移植 妊娠结局 

分 类 号：R713.5[医药卫生—妇产科学]