腹腔镜下输卵管开窗术与腹腔镜下输卵管切开缝合术对输卵管妊娠患者预后的影响比较  

Influence of laparoscopic salpingostomy vs laparoscopic salpingotomy with suturing on the prognosis of tubal pregnancy

作　　者：孙平 刘芹 SUN Ping;LIU Qin(Department of Obstetrics and Gynecology,Suzhou Hospital of Traditional Chinese Medicine,Suzhou Anhui 234000,China)

机构地区：[1]安徽省宿州市中医医院妇产科,安徽宿州234000

出　　处：《中国妇产科临床杂志》2024年第3期241-244,共4页Chinese Journal of Clinical Obstetrics and Gynecology

基　　金：2020年度安徽省自然科学基金项目(2008085QH216)。

摘　　要：目的对比分析腹腔镜下输卵管开窗术与腹腔镜下输卵管切开缝合术对输卵管妊娠患者预后的影响。方法选取2020年1月至2023年3月于安徽省宿州市中医医院妇产科行腹腔镜下手术治疗的90例输卵管妊娠患者,随机分成开窗组和切开缝合组各45例。分析比较两组患者的围术期、血β-hCG、卵巢储备功能及预后情况。结果与开窗组相比,切开缝合组患者手术时间明显更长,但术中出血量明显更少,术后3个月血清促卵泡激素(FSH)和促黄体生成素(LH)水平明显更低,雌二醇(E2)和抗苗勒管激素(AMH)水平明显更高,随访期内宫内自然妊娠发生率更高(P<0.05)。结论与腹腔镜下输卵管开窗术治疗相比,输卵管妊娠患者行腹腔镜下输卵管切开缝合术治疗虽然会延长手术时间,但减少了术中出血量,有利于卵巢储备功能恢复正常,可有效地提高宫内自然妊娠率,改善患者预后。Objective To comparatively analyze the influence of laparoscopic salpingostomy and laparoscopic salpingotomy with suturing on the prognosis of tubal pregnancy.Methods A total of 90 patients with tubal pregnancy who underwent laparoscopic surgery in the Department of Obstetrics and Gynecology at Suzhou Hospital of Traditional Chinese Medicine from January 2020 to March 2023 were selected as the study subjects.According to the random number table,the subjects were divided into salpingostomy group and salpingotomy with suturing group,with 45 patients in each group.The two groups were compared in terms of perioperative conditions,blood HCG,ovarian reserve function,the degree of fallopian tube recanalization,and the prognosis.Results Compared with the salpingostomy group,operation time was significantly longer,intraoperative blood loss was significantly less,serum follicle-stimulating hormone(FSH)and luteinizing hormone(LH)levels in 3 months after operation were significantly lower,the levels of estradiol(E2)and anti-Mullerian hormone(AMH)were significantly higher and the incidence of intrauterine natural pregnancy during follow-up period were higher in the salpingotomy with suturing group(P<0.05).Conclusion Compared with laparoscopic salpingostomy,laparoscopic salpingotomy with suturing may prolong the operation time,but it reduces intraoperative blood loss,which is conducive to the restoration of ovarian reserve function,effectively improves intrauterine natural pregnancy rate,and improve the prognosis of patients.

关 键 词：腹腔镜 输卵管开窗术 输卵管切开缝合术 输卵管妊娠 预后 

分 类 号：R713.8[医药卫生—妇产科学]