输卵管切除术治疗双侧输卵管重度积水不孕症患者的效果  

Effect of salpingectomy on infertility patients with severe bilateral hydrosalpinx

作　　者：陈耀良 施文银 柴强达 杨心运 CHEN Yaoliang;SHI Wenyin;CHAI Qiangda(Hangzhou Linping Maternal and Child Health Hospital,Zhejiang 310053,China)

机构地区：[1]浙江中医药大学,杭州310053 [2]浙江省杭州市临平区妇幼保健院 [3]浙江大学医学院附属妇产科医院

出　　处：《浙江创伤外科》2024年第6期1030-1033,共4页Zhejiang Journal of Traumatic Surgery

摘　　要：目的观察输卵管切除术治疗双侧输卵管重度积水不孕症患者的效果。方法回顾性分析2019年12月至2023年8月在临平区妇幼保健院接受治疗的62例双侧输卵管重度积水不孕症患者的临床资料,按照不同术式分为腹腔镜输卵管切除术组(n=28)与腹腔镜输卵管开窗术组(n=34),均予以体外受精-胚胎移植(IVF-ET)辅助生殖。对比两组患者手术指标,手术前后性激素[卵泡刺激素(FSH)、雌二醇(E_(2))、黄体生成素(LH)]水平,促性腺激素(Gn)用药时间和用量,取卵数目,IVF-ET后的临床妊娠和早期流产率。结果腹腔镜输卵管切除术组出血量、手术时间少于腹腔镜输卵管开窗术组(P<0.05);两组术后排气时间和住院时间比较差异无统计学意义(P>0.05)。两组患者手术前后FSH、E_(2)、LH水平比较无差异(P>0.05)。两组患者Gn用药时间、Gn用量和取卵数比较差异无统计学意义(P>0.05)。两组患者临床妊娠率及早期流产率比较差异无统计学意义(P>0.05)。结论输卵管切除术对双侧输卵管重度积水不孕症患者的卵巢功能无明显影响,可改善患者妊娠结局,且具有手术时间短、出血量少等优点。Objective To observe the effect of salpingectomy on infertility patients with severe bilateral hydrosalpinx.Methods The clinical data of 62 infertile patients with severe bilateral hydrosalpinx treated in our hospital from December 2019 to August 2023 were retrospectively analyzed,they were divided into laparoscopic salpingectomy group(n=28)and laparoscopic salpingotomy group(n=34)according to different surgical procedures,and both of them were assisted by in vitro fertilization-embryo transfer(IVF-ET).The surgical indexes,the levels of sex hormones[follicle stimulating hormone(FSH),estradiol(E_(2))and luteinizing hormone(LH)],the time and dosage of gonadotropin(Gn),the number of eggs retrieved,the clinical pregnancy and early abortion rate after IVF-ET were compared between the two groups.Results The amount of bleeding and operation time in laparoscopic salpingectomy group were less than those in laparoscopic salpingotomy group(P<0.05).There was no difference in postoperative exhaust time and hospitalization time between the two groups(P>0.05).There was no difference in the levels of FSH,E_(2) and LH between the two groups before and after operation(P>0.05).There was no difference in the time of Gn administration,the dosage of Gn and the number of eggs taken between the two groups(P>0.05).There was no difference in clinical pregnancy rate and early abortion rate between the two groups(P>0.05).Conclusion Salpingectomy has no obvious effect on ovarian function of infertile patients with bilateral severe hydrosalpinx,and can improve the pregnancy outcome,and has the advantages of short operation time and less bleeding.

关 键 词：输卵管重度积水 双侧 不孕 输卵管切除术 腹腔镜 卵巢功能 妊娠结局 

分 类 号：R714.2[医药卫生—妇产科学]