腹腔镜输卵管切开取胚术对输卵管异位妊娠的疗效分析  

Effective Analysis of Laparoscopic Tubal Incision and Embryo Extraction on Patients with Tubal Ectopic Pregnancy

作　　者：凌思芸 王利明 张蕾 LING Siyun;WANG Liming;ZHANG Lei(Department of Gynecology,Suzhou Ninth People′s Hospital Affiliated to Suzhou University,Suzhou Jiangsu 215200,China)

机构地区：[1]苏州市第九人民医院妇科,江苏苏州215200

出　　处：《华南国防医学杂志》2022年第3期178-182,共5页Military Medical Journal of South China

基　　金：苏州市吴江区科技计划项目(Y201943)。

摘　　要：目的 探讨腹腔镜输卵管切开取胚术对输卵管异位妊娠患者的疗效。方法 选择2017-02/2019-10月作者医院收治的82例输卵管异位妊娠患者,以随机数字表法均分为两组。A组行腹腔镜下输卵管切开取胚术(n=41),B组行腹腔镜下输卵管切除术(n=41)。比较两组患者手术一般情况、卵巢功能指标、应激指标、炎症因子、术后妊娠情况。结果 A组患者手术时间较B组更短、术中出血量较B组更少(P<0.05),两组术后排气时间及术后住院时间无统计学差异(P>0.05)。A组患者术前术后促卵泡生成素(follicle stimulating hormone,FSH)、促黄体生成素(luteinizing hormone,LH)、雌二醇(estradiol,E_(2))差异均无统计学意义(P>0.05);B组术后3个月患者FSH、LH高于术前,E_(2)、抗缪勒管激素(anti-mullerian hormone,AMH)均低于术前(P均<0.05)。术后24 h两组患者肾上腺素(epinephrine,E)、皮质醇(cortisol,Cor)水平均明显升高,但B组升高幅度更大,术后24 h两组患者促甲状腺激素(thyroidstimulating hormone,TSH)水平均明显下降,但B组下降更明显(P均<0.05)。术后24 h患者白细胞介素2(interleukin 2,IL-2)、IL-6、C反应蛋白(C-reactive protein,CRP)水平均明显升高,但B组升高幅度更大(P均<0.05)。B组术后1年宫外妊娠率为2.44%,与A组的4.88%差异无统计学意义(P>0.05),B组术后1年宫内妊娠率为31.71%,低于A组的53.66%(P<0.05)。结论 腹腔镜输卵管切开取胚术与腹腔镜下输卵管切除术相比,可缩短输卵管异位妊娠患者手术时间,减少术中出血量,对患者卵巢功能影响小,缓解应激反应及炎症反应,同时还可保护患者的生育能力。Objective To explore the effects of laparoscopic tubal incision and embryo extraction on patients with tubal ectopic pregnancy.Methods A total of 82 patients with tubal ectopic pregnancy admitted to author′s hospital from February 2017 to October 2019 were selected and divided into two groups by random number table.Laparoscopic tubal incision and embryo extraction were operated in group A(n=41),and laparoscopic tubal resection was aperated in group B(n=41).The general conditions of operation,ovarian function indexes,stress indexes,inflammatory factors and postoperative pregnancy conditions of the two groups were compared.Results The operation time of group A was shorter than that of group B,and the amount of intraoperative blood loss was less than that of group B(P<0.05).There were no significant differences in postoperative exhaust time and postoperative hospital stay between the two groups(P>0.05).There was no significant difference in follicle stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2)) of the patients before and after surgery in group A(P>0.05);the FSH and LH of the patients at 3 months after surgery in group B were higher than those before the surgery,and the levels of E_(2) and anti-mullerian hormone(AMH) were lower than those before the surgery(all P<0.05).The levels of epinephrine(E) and cortisol(Cor) in the two groups of patients increased significantly at 24 hours after surgery,but the increase in group B was even greater.At 24 hours after surgery,the thyroid stimulating hormone(TSH) level in two groups of patients decreased significantly,but the decrease in group B was more significant(all P<0.05).The levels of interleukin-2(IL-2),IL-6,and C-reactive protein(CRP) in patients 24 hours after surgery increased significantly,but the increase in group B was even greater(all P< 0.05).The 1-year ectopic pregnancy rate in group B was 2.44%,which was not statistically different with 4.88% in group A(P>0.05).The 1-year intrauterine pregnancy rate in group B was 31.71%,which was lower than

关 键 词：腹腔镜 输卵管切开取胚术 异位妊娠 卵巢功能 生育能力 

分 类 号：R711.7[医药卫生—妇产科学]