3D腹腔镜在输卵管妊娠切开取胚术中的应用研究  

Application study of 3D laparoscopy in the salpingotomy for tubal ectopic pregnancy

作　　者：张书敏 方月兰 戚亚兰 鲍睿 徐豆豆 曹庆玲 ZHANG Shu-min;FANG Yue-lan;QI Ya-lan(Department of Obstetrics and Gynecology,Suqian Hospital of Nanjing Drum Tower Hospital Group,the Affiliated Suqian Hospital of Xuzhou Medical University,Suqian 223800,China)

机构地区：[1]南京鼓楼医院集团宿迁医院徐州医科大学附属宿迁医院妇产科,江苏宿迁223800

出　　处：《腹腔镜外科杂志》2022年第7期552-555,共4页Journal of Laparoscopic Surgery

基　　金：2019年宿迁市产业发展引导资金(科技创新专项-重点研发计划)(社会发展)项目(S201911)。

摘　　要：目的:探讨3D腹腔镜在输卵管妊娠切开取胚术中的应用效果。方法:选择2018年1月1日至2021年1月1日因输卵管妊娠行腹腔镜切开取胚术且有生育要求的173例患者,其中研究组(n=63)行3D腹腔镜手术,对照组(n=110)行普通腹腔镜手术。经过倾向性匹配分析后最终两组各纳入63例,两组年龄、孕次、妊娠包块直径等一般情况差异无统计学意义。术后2个月行子宫输卵管造影,监测排卵情况,指导患者尽早妊娠。对比分析两组手术时间、术中出血量、持续性宫外孕、输卵管造影通畅率、再次妊娠率等。结果:研究组手术时间短于对照组,术后输卵管通畅率与再次宫内妊娠率高于对照组,差异有统计学意义(P<0.05)。结论:在输卵管妊娠切开取胚术中,3D腹腔镜较普通腹腔镜能明显缩短手术时间,提高术后输卵管通畅率及宫内妊娠率,并未增加术中出血量及持续性宫外孕发生率,值得推广应用。Objective:To explore the application effect of 3D laparoscopic salpingotomy for tubal ectopic pregnancy.Methods:A total of 173 patients with fertility requirements who underwent laparoscopic salpingotomy for tubal ectopic pregnancy from Jan.1,2018 to Jan.1,2021 were selected.63 patients in the study group underwent 3D laparoscopic surgery,110 patients in the control group underwent ordinary laparoscopic surgery.After propensity matching analysis 63 cases were included in each group,there was no statistical difference between the two groups in general conditions such as age,number of pregnancy and pregnancy mass diameter.Two months a fter the operation,the subjects underwent hysterosalpingography and ultrasound monitoring of ovulation to guide conception.The operation time,intraoperative blood loss,persistent ectopic pregnancy,tubal patency rate,and re-pregnancy rate were compared and analyzed between the two groups.Results:The operation time of the study group was shorter than that of the control group,the rate of postoperative fallopian patency and the rate of intrauterine re-pregnancy were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusions:Compared with ordinary laparoscopy,3D laparoscopy in the salpingotomy for tubal ectopic pregnancy can significantly shorten the operation time,and increase the patency rate of the fallopian tube and the rate of intrauterine pregnancy after operation,without increasing the bleeding volume and incidence of persistent ectopic pregnancy.The application of 3D laparoscopy in salpingotomy for tubal ectopic pregnancy is worthy of popularization and application.

关 键 词：妊娠 输卵管 输卵管切开取胚术 腹腔镜检查 成像 三维 

分 类 号：R713.8[医药卫生—妇产科学]