摘要
目的:分析比较腹腔镜下输卵管开窗术与切除术对输卵管妊娠患者生育功能和远期预后的影响.方法:纳入2019年1月-2022年8月本院妇科收治的输卵管妊娠患者100例,按照入院时间顺序编号分为开窗术组和切除术组各50例,分别给予腹腔镜下输卵管开窗术或输卵管切除术.分析两组手术相关指标,术后并发症发生情况,输卵管通畅情况,卵巢储备功能指标以及术后3年内妊娠情况.结果:两组血绒毛膜促性腺激素恢复时间和住院时间无差异(均P>0.05),切除术组手术用时(30.64±3.71min)、术中出血量(59.77±7.50ml)均大于开窗术组(21.38±3.04 min、43.98±6.01ml)(均P0.05).两组术后并发症发生率(32.0%、30.8%)无差异(P>0.05).开窗术组至少一侧输卵管通畅比例(96.0%)大于切除术组(80.0%),术后6个月时血清卵泡刺激素(FSH mIU/ml)(6.71±2.35)及FSH/(黄体生成素)LH(1.49±0.37)均低于切除术组(8.41±3.79mIU/ml、2.19±0.44),雌二醇(78.39±14.90pg/ml)、抗缪勒管激素(4.36±1.96μg/L)水平高于切除术组(50.74±19.02pg/ml、3.61±1.75μg/L),术后3年内宫内妊娠比例(80.0%)及再次异位妊娠比例(18.0%)均高于切除术组(54.0%、6.0%)(均P<0.05)结论:相较于腹腔镜下输卵管切除术,腹腔镜下输卵管开窗术治疗输卵管异位妊娠对患者生育功能影响更小.
Objective:To analyze and compare the effects of laparoscopic salpingotomy and salpingectomy for treating patients with tubal ectopic pregnancy on their fertility function and long-term prognosis.Methods:A total of 100 patients with tubal ectopic pregnancy were selected and were divided into two groups(50 cases in each group)according to the chronological order of admission from January 2019 to August 2022.The patients in group A were given salpingotomy and the patients in group B were given salpingectomy.The indicators related to surgery,the occurrence of postoperative complications,the tubal patency situation,the ovarian reserve function indicators,and intrauterine pregnancy rate within 3 years after surgery of the patients in the two groups were analyzed.Results:There were no significant differences in the recovery time of blood chorionic gonadotropin level and the length of hospital stay of the patients between the two groups(all P>0.05).The operation timc(30.64±3.71 min)and the intraoperative blood loss(59.77±7.50 ml)of the patients in group B were significantly higher than thosc(21.38±3.04 min and 43.98±6.01 ml)of the patients in group A(all P<0.05).There was no significant difference in the incidence of postoperative complications(32.0%vs.30.8%)of the patients between the two groups(P>0.05).The patency rate at least one fallopian tube(96.0%)of the patients in group A was significantly higher than that(80.0%)of the patients in group B.In 6 months after surgery,the levels of scrum FSH(6.71±2.35 mlU/ml)and FSH/luteinizing hormonc(LH 1.49±0.37)of the patients in group B were significantly lower than thosc(8.41±3.79 mlU/ml and 2.19±0.44)of the patients in group B.The levels of estradiol(78.39±14.90μg/ml)and anti-Mullcrian hormonc(4.36±1.96μg/L)of the patients in group B were significantly higher than thosc(50.74±19.02μg/ml and 3.61±1.75μg/L)of the patients in group B.The intrau-terine pregnancy ratc(80.0%)and the ectopic pregnancy ratc(18.0%)of the patients in group B within 3 years after surgery were significantly higher than thosc(54.0%and 6.0%)of the patients in group B(all P<70.05).Conclusion:Compared with those of laparoscopic salpingectomy,the laparoscopic tubal salpingotomy for treating the patients with tubal ectopic pregnancy has less influence on their fertility function.
作者
许晓东
李翠
于倩
易建平
杨小杰
XU Xiaodong;LI Cui;YU Qian;YI Jianping;YANG Xiaojie(Tangshan Maternal and Child Health Care Hospital,Tangshan,Hebei Province,063000)
出处
《中国计划生育学杂志》
2024年第1期48-52,共5页
Chinese Journal of Family Planning
基金
河北省卫生健康委科研基金项目(20201475)。
