输卵管妊娠行腹腔镜下改良输卵管壶腹部开窗取胚缝合术与输卵管切除术对卵巢储备功能影响  

Effect of laparoscopic improved tubal ampulla fenestration to remove embryo and suture surgery or laparoscopic salpingectomy for treating patients with tubal pregnancy on their ovarian reserve function

作　　者：余文珺 YU Wenjun(Zhejiang Chinese Medicine University/Wenzhou Hospital of Integrated Traditional Chinese and Western Medicine, Zhejiang Province, 310000)

机构地区：[1]浙江中医药大学/温州中西医结合医院,310000

出　　处：《中国计划生育学杂志》2021年第9期1877-1880,共4页Chinese Journal of Family Planning

摘　　要：目的:探讨腹腔镜下改良输卵管壶腹部开窗取胚缝合术与输卵管切除术治疗输卵管妊娠对卵巢储备功能的影响。方法:回顾性分析2018年10月—2019年10月本院收治的输卵管妊娠患者89例临床资料,根据手术方式不同分为对照组(腹腔镜下输卵管切除术治疗,44例)和观察组(腹腔镜下改良输卵管壶腹部开窗取胚缝合术治疗,45例)。比较两组治疗前后血清性激素水平、手术相关指标、卵巢储备功能、术后2年妊娠情况。结果:观察组手术时间(61.8±6.5min)长于对照组(54.9±5.3min)(P<0.05),两组术中出血量、下床活动时间、出院时间以及术后2年重复性异位妊娠率无差异(P>0.05)。出院时及出院后6个月,观察组卵泡刺激素、雌二醇和抗缪勒管激素水平均低于对照组,促黄体生成素水平高于对照组(P<0.05)。两组患侧出院时、健侧出院时及出院后6个月的卵巢AFC无差异(P>0.05),出院后6个月观察组患侧卵巢窦卵泡(AFC)(5.9±1.7个)高于对照组(3.5±1.5个);术后2年宫内妊娠率观察组(75.6%)高于对照组(64.6%)(P<0.05)。结论:腹腔镜下改良输卵管壶腹部开窗取胚缝合术对患者卵巢储备功能影响更小,可降低医源性卵巢功能损害。Objective:To investigate the effect of laparoscopic improved tubal abdomen fenestration to remove embryo and suture or laparoscopic salpingectomy for treating patients with tubal ectopic pregnancy on their ovarian reserve function.Methods:The clinical data of 89 patients with tubal ectopic pregnancy from October 2018 to October 2019 were analyzed retrospectively.According to the different surgical methods,these patients were divided into control group(44 patients accepted laparoscopic salpingectomy)and observation group(45 patients accepted laparoscopic improved tubal abdomen fenestration to remove embryo and suture).The serum hormone level,surgical-related indicators,ovarian reserve function,and pregnancy within 2 years after surgery of the patients were compared between the two groups.Results:The operation time(61.8±6.5min)of the patients in the observation group was significant longer than that(54.9±5.3min)of the patients in the control group(P<0.05).There were no significant differences in the intraoperative blood loss,time of getting out of bed,time of hospital stay,and the rate of repetitive ectopic pregnancy within 2 years after operation of the patients between the two groups(P>0.05).At hospital discharge and 6 months after hospital discharge,the levels of FSH,estradiol,and AMT of the patients in the observation group were significant lower than those of the patients in the control group,but the level of luteinizing hormone of the patients in the observation group was significant higher(P<0.05).There was no significant difference in the AFC of the ovary in the same side of tubal ectopic pregnancy at hospital discharge,and in the AFC of the ovary in the other side of tubal ectopic pregnancy at hospital discharge and 6 months after hospital discharge of the patients between the two groups(P>0.05).The AFC(5.9±1.7)of the ovary in the same side of tubal ectopic pregnancy of the patients in the observation group 6 months after hospital discharge was significant higher than that(3.5±1.5)of the patients in th

关 键 词：输卵管妊娠 输卵管切除术 开窗取胚缝合术 卵巢储备功能 

分 类 号：R713.5[医药卫生—妇产科学]