腹腔镜下保留输卵管功能在输卵管妊娠患者中的应用效果研究  

Study on the effect of laparoscopic preservation of fallopian tube function in patients with tubal pregnancy

作　　者：李丹[1] 吴晓兰[1] LI Dan;WU Xiaolan(Department of Maternity,Chengdu Fifth People′s Hospital,Chengdu,Sichuan 611130,China)

机构地区：[1]成都市第五人民医院妇产科,四川成都611130

出　　处：《现代医药卫生》2022年第4期555-557,562,共4页Journal of Modern Medicine & Health

基　　金：四川省科学技术厅科技计划项目(2018SZ0260)。

摘　　要：目的 研究腹腔镜下保留输卵管功能的有效性、安全性及对远期生育功能的影响。方法 选取2018年5月至2019年5月该院收治的输卵管妊娠患者100例作为研究对象,随机分为研究组和对照组,每组50例。研究组行输卵管线性切开取胚,输卵管系膜缘缝合,恢复输卵管的解剖结构;对照组行输卵管线性切开取胚,电凝止血,未缝合输卵管。比较2组腹腔镜手术的手术时间,术中出血情况,术前、术后1d、术后3d、术后7d的血清β-人绒毛膜促性腺激素(HCG)水平,住院时间,术后肛门恢复通气情况,尿管拔除时间,输卵管通畅情况,随访再次自然妊娠情况。结果 研究组手术时间长于对照组,输卵管通畅情况、再次自然妊娠情况优于对照组,差异均有统计学意义(P<0.05)。2组在术中出血情况、术后肛门恢复通气情况、术后HCG水平、住院时间及术后尿管拔出时间方面比较,差异均无统计学意义(P>0.05)。结论 腹腔镜下保留输卵管功能安全有效,有助于保留患者生育能力。Objective To investigate the efficacy and safety of preserving fallopian tube function under laparoscopy,and its effect on long-term reproductive function.Methods A total of 100 patients with tubal pregnancy admitted to a hospital from May 2018 to May 2019 were selected and randomly divided into the study group and control group.There were 50 patients in each group.In the study group,the embryo was removed by linear tubal incision and the mesosalpinx margin was sutured to restore the anatomical structure of the fallopian tubes.In the control group,the oviduct was linearly cut and embryos were removed,the bleeding was stopped by electrocoagulation,and the oviduct was not sutured.The operative time,intraoperative bleeding,serumβ-human chorionic gonadotropin(HCG)value before surgery,1,3 and 7 days after surgery,length of hospital stay,recovery of anal ventilation after surgery,catheter removal time,degree of fallopian tube patency and recurrence rate of natural pregnancy were compared between the two groups.Results Compared with those of the control group,the operative time was longer,and the degree of fallopian tube patency and the rate of second natural pregnancy were significantly better in the study group(P<0.05).However,there were no significant differences in intraoperative bleeding,postoperative anal ventilation,postoperative HCG decline,length of hospital stays and postoperative catheter extraction time between the two groups(P>0.05).Conclusion Laparoscopic preservation of fallopian tube function is safe and effective in patients with tubal pregnancy,which is helpful to preserve the fertility of patients.

关 键 词：腹腔镜 输卵管妊娠 缝合 生育功能 

分 类 号：R713.8[医药卫生—妇产科学]