异位妊娠腹腔镜输卵管切除术对患者血清性激素和AMH水平的影响  

Efects of laparoscopic salpingectomy for treating women with fallopian ectopic pregnancy on their serum sex hormones and anti-Mullerian hormone levels

作　　者：屠琴 TU Qin(Qingbaijiang District People's Hospital,Chengdu,Sichuan Province,610300)

机构地区：[1]四川省成都市青白江区人民医院,610300

出　　处：《中国计划生育学杂志》2023年第3期590-593,共4页Chinese Journal of Family Planning

摘　　要：目的:探究腹腔镜输卵管切除术对急诊异位妊娠患者血清性激素和抗穆勒式管激素(AMH)水平的影响。方法:收集2019年1月-2021年1月本院急诊科或急门诊收治的95例异位妊娠患者作为研究对象,按照手术方式不同分为组,其中49例采用腹腔镜下输卵管切除术治疗(切除组),46例行输卵管开窗手术(保守组),对比两组围手术期情况、血清性激素、AMH水平及术后随访再妊娠情况。结果:两组妊娠部位、盆腔粘连、对侧输卵管异常、术中出血量、手术时间、住院时间等比较均无差异(P>0.05);术前和术后6个月血清性激素水平两组无差异,术后3个月切除组血清促卵泡生成素(7.46±1.42 mIU/ml)、雌二醇(57.98±10.16 pg/ml)高于保守组(6.74±1.78 mIU/ml、40.15±11.04 pg/ml),术后随访1年再发异位妊娠切除组(4.1%)低于保守组(17.4%)(均P<0.05),术后1年两组宫内妊娠率无差异。结论:腹腔镜下输卵管切除术与输卵管开窗手术效果相当,术后再发异位妊娠率更低,但对患者术后近期FSH、E_2水平造成一定影响,临床治疗中应根据实际情况选择合理的手术方式。Objective:To study the effects of laparoscopic salpingectomy for treating women with emergency fallopian ectopic pregnancy on the levels of the serum sex hormones and anti Mullerian hormone(AMH).Methods:95 women with ectopic pregnancy who were admitted to emergency outpatient department of the hospital between January 2019 and January 2021 were collcted as the research subjects,and these women were divided into two groups according to different surgical methods.Among these women,49 cases were treated with laparoscopic salpingectomy in group A,and 46 cases underwent fallopian fenestration were in group B.The perioperative status,the levels of serum sex hormones and AMH,and the situation of postoperative follow up of the women were compared between the two groups.Results:There were no significant differences in the pregnancy site,pelvic adhesion,contralateral fallopian tube ab-normality,intraoperative blood loss,operation time,and hospital stay of the women between the two groups(P>0.05).There was no significant difference in the serum sex hormone level of the women before surgery and in the 6th month after surgery between the two groups.The serum follicle stimulating hormone level(7.46±1.42 mIU/ml)and estradiol(57.98±10.16 pg/ml)level of the women in group A in the 3rd month after surgery were significantly higher than those(6.74±1.78 mIU/ml and 40.15±11.04 pg/ml)of the women in group B.The recurrence of ectopic pregnan-cy of the women in group A within 1 year of follow up after surgery was 4.1%,which was significantly lower than that(17.4%)of the women in group B(all P<0.05).There was no significant difference in the rate of intrauterine pregnancy of the women within 1 year after surgery between the two groups.Conclusion:Compared with those of fallopian fenestration,laparoscopic salpingectomy for treating women with ectopic pregnancy has the same surgical effect,with lower recurrent ectopic pregnancy rate after surgery,however,which affects the FSH,Ex,and AMH levels of the women in the near future after surge

关 键 词：异位妊娠 腹腔镜输卵管切除术 输卵管开窗手术 急诊手术 血清性激素 抗穆勒式管激素 卵巢储备 再妊娠 

分 类 号：R713.8[医药卫生—妇产科学]