腹腔镜保守手术治疗异位妊娠患者的临床疗效  

Clinical Efficacy of Laparoscopic Conservative Surgery for Patients with Ectopic Pregnancy

作　　者：燕海亚[1] 刘学军 闫欢 储慧 YAN Haiya;LIU Xuejun;YAN Huan(Department of Women First,Baoji City Maternal and Child Health Care Hospital,Baoji Shaanxi 721000)

机构地区：[1]宝鸡市妇幼保健院妇一科,陕西宝鸡721000 [2]宝鸡市妇幼保健院妇科门诊实验室,陕西宝鸡721000

出　　处：《医学临床研究》2023年第11期1707-1709,共3页Journal of Clinical Research

摘　　要：【目的】探讨腹腔镜保守手术治疗异位妊娠患者的临床疗效。【方法】选取宝鸡市妇幼保健院2020年3月至2022年7月收治的82例异位妊娠患者,根据适应证和患者自己的意愿分为切除组(给予腹腔镜输卵管切除术治疗)和保守组(给予腹腔镜保守术治疗),分析两组患者治疗后的临床疗效。【结果】保守组术中出血量少于切除组,血人绒毛膜促性腺激素(β-HCG)恢复正常时间、住院时间短于切除组(P<0.05)。两组术前生殖激素水平比较,差异无统计学意义(P>0.05);保守组术后1个月、3个月时雌二醇(E_(2))、抗苗勒管激素(AMH)水平高于切除组,卵泡刺激素(FSH)水平低于切除组,但黄体生成素(LH)水平与切除组同时间点比较,差异无统计学意义(P>0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。保守组术后3年内自然妊娠率和总妊娠率均高于切除组,但两组辅助生殖妊娠率和再次异位妊娠率比较,差异无统计学意义(P>0.05)。【结论】与输卵管切除术比较,腹腔镜保守术对患者生殖激素水平影响较小,可加快术后血β-HCG的恢复速度,缩短住院时间,提高术后3年内再次妊娠率。【Objective】To explore the clinical efficacy of laparoscopic conservative surgery for patients with ectopic pregnancy.【Methods】A total of 82 patients with ectopic pregnancy admitted to Baoji Maternal and Child Health Hospital from March 2020 to July 2022 were selected and divided into a resection group(treated with laparoscopic salpingectomy)and a conservative group(treated with laparoscopic conservative surgery)according to the indications and the patients'own wishes.The clinical efficacy of the two groups was analyzed after treatment.【Results】The amount of intraoperative bleeding in the conservative group was less than that in the resection group,and the time for bloodβ-HCG to return to normal and the length of hospital stay were shorter than those in the resection group(P<0.05).There was no significant difference in the preoperative reproductive hormone levels between the two groups(P>0.05).The levels of estradiol(E_(2))and anti-Mullerian hormone(AMH)in the conservative group were higher than those in the resection group at 1 month and 3 months after surgery,while the level of follicle stimulating hormone(FSH)was lower than that in the resection group.However,there was no significant difference in the level of luteinizing hormone(LH)between the two groups at the same time point(P>0.05).There was no significant difference in the incidence of complications between the two groups after surgery(P>0.05).The natural pregnancy rate and total pregnancy rate within 3 years after surgery were higher in the conservative group than in the resection group,but there was no significant difference in the rates of assisted reproductive pregnancy and recurrent ectopic pregnancy between the two groups(P>0.05).【Conclusion】Compared with salpingectomy,laparoscopic conservative surgery has less impact on reproductive hormone levels,can accelerate the recovery of bloodβ-HCG,shorten the length of hospital stay,and improve the rate of pregnancy again within 3 years after surgery.

关 键 词：妊娠 异位/外科学 腹腔镜检查 治疗结果 

分 类 号：R714.22[医药卫生—妇产科学]