宫腹腔镜术后输卵管微小病变患者妊娠情况分析  

Analysis of pregnancy in patients with minor tubal lesions after uterine laparoscopy

作　　者：张乐梅 宋清霞[2] Zhang Lemei;Song Qingxia(Anhui University of Traditional Chinese Medicine,Hefei 230000,China;Department First of Gynecology Suzhou TCM Hospital Affliated to Nanjing University of Chinese Medicine,Suzhou 215000,China)

机构地区：[1]安徽中医药大学,安徽合肥230000 [2]南京中医药大学附属苏州市中医医院妇科一,江苏苏州215000

出　　处：《实用妇科内分泌电子杂志》2023年第27期15-17,共3页Electronic Journal of Practical Gynecological Endocrinology

基　　金：苏州市科技计划项目(编号SKY2021057)。

摘　　要：目的 分析输卵管微小病变患者经宫腹腔镜手术后妊娠的影响因素。方法 回顾性分析本院72例行宫腹腔镜手术中诊断为输卵管微小病变不孕症患者的临床资料。术后随访其妊娠情况,比较妊娠组与非妊娠组之间的相关因素差异,分析宫腹腔镜术后可能影响妊娠的因素。结果 根据术后随访结果,妊娠38例,非妊娠34例,总妊娠率为52.78%。与非妊娠组相比,妊娠组患者手术时间较短,输卵管囊化、输卵管憩室及术前通而不畅比例较少,输卵管系膜囊肿占比较多,中药治疗患者较多,差异有统计学意义(P<0.05)。多因素Logistic回归分析显示:输卵管系膜囊肿是术后妊娠的独立影响因素(P<0.05)。结论 病变范围较小,受损较轻类型的输卵管微小病变的不孕症患者在宫腹腔镜手术后效果较明显。但术中应注意仔细鉴别输卵管微小病变并相应处理,恢复输卵管原有结构及功能,可提高患者妊娠率。Objective To analyze the influencing factors of pregnancy in patients with minor tubal lesions after laparoscopic uterine surgery.Methods The clinical data of 72 infertility patients diagnosed with minor tubal lesions during uterine laparoscopic surgery in our hospital were retrospectively analyzed,and their pregnancy conditions were followed up after surgery.The differences of related factors between the pregnant group and the non-pregnant group were compared,and the factors that may affect pregnancy after uterine laparoscopic surgery were analyzed.Results According to the postoperative follow-up results,there were 38 pregnant cases and 34 non-pregnant cases,with a total pregnancy rate of 52.78%.Compared with the non-pregnant group,the operation time of the pregnant group was shorter,the proportion of tubal sac,tubal diverticulum and preoperative obstruction was less,there were more mesofilm cysts,and more patients were treated with Chinese medicine,the difference was statistically significant(P<0.05).Multivariate Logistic regression analysis showed that mesangial tubal cyst was an independent factor of postoperative pregnancy(P<0.05).Conclusion The effect of uterine laparoscopic surgery was more obvious in infertile patients with small lesions and mild types of tubal microlesions.However,during the operation,attention should be paid to carefully identify the small lesions of the fallopian tube and treat them accordingly to restore the original structure and function of the fallopian tube,which can improve the pregnancy rate of patients.

关 键 词：输卵管微小病变 宫腹腔镜手术 妊娠 不孕症 

分 类 号：R713.4[医药卫生—妇产科学]