腹腔镜下输卵管妊娠孕段切除-端端吻合术治疗输卵管妊娠的临床价值分析  

Clinical Value Analysis of Laparoscopic Tubal Pregnancy Segment Resection and End-To-End Anastomosis for Tubal Pregnancy

作　　者：罗裕 潘如 雷南香 张惠 杨海坤[1] LUO Yu;PAN Ru;LEI Nanxiang;ZHANG Hui;YANG Haikun(Meizhou City People's Hospital(Huangtang Hospital),Department of Gynecology,Meizhou City Academy of Medical Sciences,Meizhou,Guangdong 514031)

机构地区：[1]梅州市人民医院(黄塘医院)/梅州市医学科学院妇科,广东梅州514031

出　　处：《智慧健康》2023年第19期109-112,共4页Smart Healthcare

基　　金：梅州市医药卫生科研项目《腹腔镜下输卵管妊娠孕段切除-端端吻合术在临床中的应用》(项目编号:2020-B-37)。

摘　　要：目的比较腹腔镜下输卵管妊娠孕段切除-端端吻合术、腹腔镜下输卵管开窗取胚术与腹腔镜下输卵管切除术治疗输卵管妊娠的临床价值。方法回顾性分析2019年7月-2022年12月梅州市人民医院收治的298例输卵管妊娠患者,按照治疗的不同手术方式分成A组采用腹腔镜下输卵管妊娠孕段切除-端端吻合术(n=53)、B组采用腹腔镜下输卵管切开取胚术(n=112)和C组采用腹腔镜下输卵管切除术(n=123),比较各组的手术持续时间、术中出血量、住院时间、再次异位妊娠发生率、术后宫内妊娠率、不孕发生率的差异。结果A组手术持续时间显著高于B组和C组。三组患者的术中出血量、住院时间组间差异无统计学意义(P>0.05);A组住院时间显著低于B组和C组。A组术后宫内妊娠率显著高于B组和C组(P=0.042);A组术后不孕率显著低于B组和C组(P=0.042)。结论与其他术式相比,输卵管妊娠孕段切除-端端吻合术手术持续时间相对较长,术后宫内妊娠率更高,术后不孕率更低。Objective To compare clinical value of laparoscopic tubal pregnancy segment resection end-to-end anastomosis,laparoscopic fallopian tube fenestration embryo retrieval,laparoscopic fallopian tube resection in treatment of fallopian tube pregnancy.Methods The paper reviewed and analyzed tubal pregnancy patients admitted to Meizhou City People's Hospital from July 2019 to December 2022,and divided them into three groups according to treatment methods.Difference of surgery duration,intraoperative bleeding amount,length of stay,incidence of recurrent ectopic pregnancy,rate of postoperative intrauterine pregnancy and incidence of infertility in each group was compared.Results During perioperative period,there was statistically significant difference in average surgical duration among three groups(P<0.001).Surgical duration of fallopian tube pregnancy segment resection end to end anastomosis group was significantly higher than other two groups.There was no significant difference in intraoperative bleeding volume and hospital stay among three groups(P>0.05).Follow-up showed postoperative intrauterine pregnancy rate in fallopian tube pregnancy segment resection end to end anastomosis group(52.9%)was significantly higher than fallopian tube fenestration embryo retrieval group(25.0%)(P=0.042).Postoperative infertility rate(41.2%)in fallopian tube pregnancy segment resection end to end anastomosis group was significantly lower than fallopian tube fenestration embryo retrieval group(70.8%)(P=0.042).Conclusion Duration of tubal pregnancy segment resection end to end anastomosis surgery is relatively longer and postoperative intrauterine pregnancy rate is higher,while postoperative infertility rate is lower than other surgical methods.

关 键 词：输卵管妊娠 输卵管妊娠段切除术 端端吻合术 输卵管开窗取胚术 

分 类 号：R714.221[医药卫生—妇产科学]