腹腔镜下不同术式治疗输卵管积水对近远期卵巢储备功能及妊娠结局的影响  

Effect of different laparoscopic methods on near-and long-term ovarian reserve and pregnancy outcomes in the treatment of hydrosalpinx

作　　者：胡启彩 曹炎培[2] 香钰婷 张薇[1] 魏蔚霞[1] HU Qicai;CAO Yanpei;XIANG Yuting;ZHANG Wei;WEI Weixia(Department of Obstetrics and Gynecology;Reproductive Medicine Center,Peking University Shenzhen Hospital,Shenzhen Guangdong 518036,P.R.China)

机构地区：[1]北京大学深圳医院妇产科,广东深圳518036 [2]北京大学深圳医院生殖医学中心,广东深圳518036

出　　处：《中国计划生育和妇产科》2021年第4期51-53,共3页Chinese Journal of Family Planning & Gynecotokology

基　　金：广东省医学科学技术研究基金项目(项目编号:A2019035)。

摘　　要：目的比较腹腔镜下输卵管切除术及结扎造口术处理输卵管积水对近远期卵巢储备功能及体外受精-胚胎移植妊娠结局的影响。方法回顾性分析2016年1月至2019年2月于北京大学深圳医院行腹腔镜手术治疗双侧输卵管积水100例患者的临床资料,按照手术方式分为腹腔镜双侧输卵管切除组(A组,28例)及输卵管近端结扎远端造口组(B组,72例)。比较两组术后1月及1年相关性激素、抗苗勒氏管激素(anti-mullerian hormone,AMH)、窦卵泡数(antral follicle count,AFC)及妊娠结局。结果(1)A组术后1月卵泡刺激素(follicle-stimulating hormone,FSH)[(8.33±2.06)IU/L]及雌二醇(estrogen,E_(2))[(57.07±10.53)pg/mL]高于B组[(6.70±1.45)IU/L、(38.06±13.75)pg/mL],差异有统计学意义(P<0.05);术后1年两组间FSH、黄体生成素、E_(2)、AMH及AFC比较,差异均无统计学意义(P>0.05)。(2)A组临床妊娠率及活产率分别为50.0%及35.7%,B组为58.3%与50%,两组比较差异无统计学意义(P>0.05)。结论腹腔镜输卵管切除术及结扎造口术处理输卵管积水均可改善辅助生育结局;腹腔镜输卵管切除术可能影响卵巢近期储备功能,但未影响卵巢远期储备功能。Objective To compare the effect of different laparoscopic methods on near-and long-term ovarian reserve and in vitro fertilization and embryo transfer(IVF-ET)pregnancy outcomes in the treatment of hydrosalpinx.Methods Data of patients with bilateral hydrosalpinx who underwent laparoscopic surgery in Peking University Shenzhen Hospital from January 2016 to February 2019 were retrospectively analyzed,which were divided into the laparoscopic bilateral salpingectomy group(group A,28 patients)and the proximal ligation distal ostomy group(group B,72 patients).The changes of related sex hormones,anti-mullerian hormone(AMH)and antral follicle count(AFC)at 1 month and 1 year after operation were compared between the two groups.Results(1)Follicle-stimulating hormone(FSH)[(8.33±2.06)IU/L]and estradiol(E_(2))[(57.07±10.53)pg/mL]in group A were higher than those in group B[(6.70±1.45)IU/L,(38.06±13.75)pg/mL]one month after operation,the differences were statistically significant(P<0.05);there was no significant difference in FSH,luteinizing hormone(LH),E_(2),AMH and AFC between the two groups at 1 year after the operation(all P>0.05).(2)The clinical pregnancy rate and live birth rate in group A were 50.0%and 35.7%,respectively,and in group B were 58.3%and 50%.There was no statistically significant difference between the two groups(P>0.05).Conclusion Both laparoscopic salpingectomy and ligation of the oviduct can improve the outcome of assisted reproduction.Laparoscopic salpingectomy may have an effect on the short-term ovarian reserve,but it has not been observed that it affects the ovarian long-term reserve function.

关 键 词：输卵管积水 腹腔镜 卵巢储备功能 妊娠结局 

分 类 号：R711.77[医药卫生—妇产科学]