超声引导下胚胎绞杀治疗输卵管妊娠的临床研究  

Clinical Study on Ultrasound-guided Embryo Strangulation for Tubal Pregnancy

作　　者：范伟博[1] 王薇[2] FAN Weibo;WANG Wei(Ultrasound Department,Yangtze University Affiliated Jingzhou Hospital,Jingzhou,Hubei 434020;Reproductive Medicine Department,Yangtze University Affiliated Jingzhou Hospital,Jingzhou,Hubei 434020)

机构地区：[1]长江大学附属荆州医院超声科,湖北荆州434020 [2]长江大学附属荆州医院生殖医学科,湖北荆州434020

出　　处：《智慧健康》2023年第17期179-182,共4页Smart Healthcare

摘　　要：目的 探索超声引导胚胎绞杀在治疗输卵管妊娠中的临床意义。方法 选择2017年12月-2019年12月因输卵管妊娠于荆州市中心医院住院接受腹腔镜下输卵管切开取胚术患者135例(A组)和超声引导下胚胎绞杀治疗的患者41例(B组),随访两组患者2年内自然妊娠结局。同时比较两组患者平均住院日及住院费用、术后3个月第3个月经周期第3d的基础卵泡刺激素(bFSH)、黄体生成素(bLH)、雌二醇(bE2)、抗缪勒管激素(AMH),以及B超计数双侧卵巢2~9mm窦卵泡数(AFC),第3个周期月经输卵管畅通情况。结果 两组患者治疗后卵巢储备功能,包括术后3个月后月经第3d的bFSH、bLH、bE2、AMH以及AFC均无明显统计学差异(P>0.05)。两组患者治疗后的一侧卵巢或双侧卵巢通畅率均无明显统计学差异(P>0.05);两组患者在治疗2年妊娠结局,包括未妊娠率、宫内妊娠率、异位妊娠及自然流产率均无明显统计学差异(P>0.05)。两组患者平均住院日及平均住院天数B组患者均小于A组患者,有统计学差异(P<0.05)。结论 与腹腔镜下输卵管切开取胚术相比较,超声引导下胚胎绞杀术患者两年宫内妊娠率、异位妊娠率、自然流产率无显著性差异,对于患者的卵巢功能储备和输卵管通畅情况两组患者也无显著性差异,超声引导下胚胎绞杀术可有效降低患者的平均住院日和住院费用。Objective To explore clinical significance of ultrasound-guided embryo strangulation in treatment of tubal pregnancy.Methods The paper chose 135 patients(group A)and 41 patients(group B)hospitalized in Jingzhou Central Hospital for"tubal pregnancy"from December 2017 to December 2019,treated with laparoscopic tubotomy for embryo extraction and ultrasound-guided embryo strangulation.Natural pregnancy outcomes between two groups were followed up for 2 years.At the same time,average length of stay and cost of hospitalization,basic follicle stimulating hormone(bFSH),Luteinizing hormone(bLH),estradiol(bE2),anti Mullerian hormone(AMH)and number of 2-9mm sinus follicles(AFC)in bilateral ovaries counted by B-ultrasound on the third day of third menstrual cycle was compared between two groups.Results There was no significant statistical difference in ovarian reserve function between two groups after treatment,including bFSH,bLH,bE2,AMH and AFC on the third day of menstruation three months after surgery(P>0.05).There was no significant statistical difference in patency rate of one or both ovaries between two groups after treatment(P>0.05).There was no significant statistical difference in pregnancy outcomes between two groups after treatment for 2 years,including non pregnancy rate,intrauterine pregnancy rate,ectopic pregnancy and spontaneous abortion rate(P>0.05).Average length of stay and average length of stay between two groups in group B was less than group A,with statistical difference(P<0.05).Conclusion Compared with laparoscopic oviduct incision for embryo extraction,ultrasound guided embryo strangulation has no significant difference in intrauterine pregnancy rate,ectopic pregnancy rate and spontaneous abortion rate of in two years,with no significant difference in ovarian function reserve and oviduct patency between two groups.Ultrasound guided embryo strangulation can reduce average hospital stay and hospital costs of patients effectively.

关 键 词：输卵管妊娠 输卵管切开取胚术 超声引导下胚胎绞杀 

分 类 号：R714.221[医药卫生—妇产科学]