输卵管妊娠腹腔镜下开窗取胚术与输卵管切除术临床疗效及生育力结局比较  

Comparison of Clinical Efficacy and Fertility Outcomes of Laparoscopic Fenestration and Salpingectomy for Tubal Pregnancy

作　　者：吴晓云[1] WU Xiaoyun(Department of Gynecology and obstetrics,Xiamen University Affiliated First Hospital Xinglin Branch,Xiamen 361100,China)

机构地区：[1]厦门大学附属第一医院杏林分院妇产科,厦门361100

出　　处：《中国医药指南》2024年第32期98-101,共4页Guide of China Medicine

摘　　要：目的分析比较输卵管妊娠腹腔镜下开窗取胚术与输卵管切除术的临床疗效及生育力结局。方法研究对象选取117例输卵管妊娠患者,均为某院2018年1月至2023年12月所收治,按照手术方法的不同将其分成两组,对照组(45例)接受输卵管切除术治疗,研究组(72例)则接受腹腔镜下开窗取胚术治疗,对两组的治疗效果及生育力结局进行观察。结果与对照组相比,研究组的手术时间、β-HCG恢复正常的时间均更长(P<0.05)。与对照组相比,研究组术后3 d、术后7 d的β-HCG下降率均更低(P<0.05)。与对照组术后3个月相比,研究组的AMH、E2水平更高(P<0.05),而FSH、LH水平则更低(P<0.05)。与对照组相比,研究组术后3个月、6个月的窦卵泡个数、卵巢体积均更高(P<0.05)。与对照组相比,研究组的宫内妊娠率更高(P<0.05);在妊娠生化流产率、异位妊娠率方面,两组比较差异无统计学意义(P>0.05)。结论在治疗输卵管妊娠患者时,和输卵管切除术相比较,采用腹腔镜下开窗取胚术治疗虽然手术操作时间更长,同时术后血清β-HCG水平需要更长时间才能恢复,但是却能对患者卵巢生殖功能进行有效保护,对激素水平及生育力结局进行改善,让宫内妊娠率提高。Objective To analyze and compare the clinical efficacy and fertility outcomes of laparoscopic fenestration and salpingectomy in tubal pregnancy.methods The subjects of the study were 117 patients with tubal pregnancy,all of whom were admitted to a hospital from January 2018 to December 2023.They were divided into two groups according to different surgical methods.The control group(45 cases)received salpingectomy treatment,and the study group(72 cases)received laparoscopic windowing embryo extraction treatment.Results Compared with the control group,the operation time andβ-HCG recovery time of the study group were significantly longer(P<0.05).Compared with the control group,theβ-HCG decreased significantly in the study group at 3 and 7 days after surgery(P<0.05).Compared with the control group 3 months after operation,AMH and E2 levels in the study group were significantly higher(P<0.05),while FSH and LH levels were significantly lower(P<0.05).Compared with the control group,the number of sinus follicles and ovarian volume in the study group were significantly higher at 3 and 6 months after operation(P<0.05).Compared with the control group,the intrauterine pregnancy rate in the study group was higher(P<0.05).There was no significant difference in biochemical abortion rate and ectopic pregnancy rate between the two groups(P>0.05).Conclusions In the treatment of patients with tubal pregnancy,compared with salpingectomy,laparoscopic windowing embryo extraction,although the operation time is longer and the postoperative serumβ-HCG level takes longer to recover,can effectively protect the patient’s ovarian reproductive function,significantly improve hormone levels and fertility outcomes,and significantly increase the intrauterine pregnancy rate.

关 键 词：输卵管妊娠 腹腔镜下开窗取胚术 输卵管切除术 临床疗效 生育力结局 

分 类 号：R714.4[医药卫生—妇产科学]