摘要
目的:探究腹腔镜下输卵管妊娠物清除+近端阻断术对患者卵巢储备功能及生育功能的影响。方法:选取本院2013年1月-2017年6月收治的输卵管妊娠患者140例临床资料,根据手术方式不同分为A、B、C组,A组(腹腔镜下输卵管妊娠物清除+近端阻断术)43例,B组(腹腔镜下输卵管保守手术)61例,C组(腹腔镜下输卵管切除术)36例。观察3组术后性激素水平、卵巢储备功能及生育功能。结果:术后1、3、12个月,3组性激素(FSH、LH及E2)水平无差异,且组内比较也无差异(P>0.05);A、B两组卵巢窦卵泡数及卵巢截面积均大于C组,卵巢动脉阻力指数低于C组(均P<0.05),但A、B两组无差异(P>0.05);术后1年,宫内妊娠率A组(83.7%)>B组(65.6%)>C组(41.7%)(P<0.05),异位妊娠率A组(11.6%)、B组(14.8%)低于C组(33.35)(P<0.05),但A、B两组无差异(P>0.05);不孕率A组(4.7%)低于B组(19.8)、C组(25.0%)(P<0.05)。结论:腹腔镜下输卵管妊娠物清除+近端阻断术治疗对输卵管妊娠患者的卵巢储备功能影响最小,可有效提高患者的成功妊娠率。
Objective:To explore the effect of laparoscopic tubal pregnancy clearance combined with proximal obstruction for treating patients with tubal pregnancy on their ovarian reserve function and reproductive function.Methods:140 patients with tubal pregnancy were selected as the subjects and were divided into three groups according to the different surgical methods from January 2013 to June 2017.43 patients in group A were given laparoscopic tubal pregnancy clearance combined with proximal obstruction,61 patients in group B were given laparoscopic conservative salpingectomy,and 36 patients in group C were given laparoscopic salpingectomy.The postoperative sex hormone levels,ovarian reserve function,and reproductive function of patients in three groups were observed.Results:There were no significant difference in the levels of FSH,LH and E2 of all patients between before operation and 1 month,3 months and 1 year after operation,and there were no significant difference in the levels of FSH,LH and E2 of patients among the three groups(P>0.05).The number of ovarian sinus follicles and the ovarian cross-sectional area of patients in group A and B were significant higher than those of patients in group C,but the resistance index of ovarian artery of patients in group A and B was significant lower(P<0.05),but there were no significant difference in the number of ovarian sinus follicles,the ovarian cross-sectional area,and the resistance index of ovarian artery of patients between group A and B(P>0.05).1 year after operation,the intrauterine pregnancy rate of patients in group A was 83.7%,which was significant higher than that(65.6%)of patients in group B,and that of patients in group B was significant higher than that(41.7%)of patients in group C(P<0.05),but there were no significant difference in intrauterine pregnancy rate of patients between group A and B(P>0.05).The rate of ectopic pregnancy of patients in group A and B was 11.6%or 14.8%,which was significant lower than that(33.4%)of patients in group C(P<0.05),but there were no significant difference in the rate of ectopic pregnancy of patients between group A and B(P>0.05).The rate of infertility rate of patients in group A was 4.7%,which was significant lower than that(19.8%)of patients in group B that(25.0%)of patients in group C(P<0.05).Conclusion:Laparoscopic tubal pregnancy clearance combined with proximal obstruction for treating patients with tubal pregnancy has less adverse effect on their ovarian reserve function,and can improve the success rate of pregnancy effectively.
作者
张璇
杜海霞
黄虹
张金燕
ZHANG Xuan;DU Haixia;HUANG Hong;ZHANG Jinyan(Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, 100026)
出处
《中国计划生育学杂志》
2020年第5期652-655,共4页
Chinese Journal of Family Planning
关键词
输卵管妊娠
腹腔镜下输卵管妊娠物清除
近端阻断术
卵巢储备功能
生育功能
Tubal pregnancy
Laparoscopic tubal pregnancy clearance
Proximal obstruction
Ovarian reserve function
Reproductive function
