腹腔镜下输卵管线形切开术治疗输卵管妊娠的效果及其对患者预后的影响

摘要

Objective To investigate the effect of laparoscopic linear salpingotomy on tubal pregnancy.Methods A total of 127 patients with tubal pregnancy undergoing laparoscopic salpingotomy from January 2015 to December 2016 in Jizhong Energy Fengfeng Group Hospital were enrolled.According to the operation scheme,the patients were divided into conservative surgery group(n =69,linear salpingotomy) and radical surgery group(n =58,radical salpingectomy).Surgical effect,intrauterine pregnancy rate and ectopic pregnancy recurrence rate in 18 months after surgery were analyzed.Results There was no significant difference of intraoperative bleeding volume,operation time,recovery time of human chorionic gonadotropin,hospitalization time and surgical success rate between groups(P ＞ 0.05).During 18 months of follow-up,the intrauterine pregnancy rate in conservative surgery group and the recurrence rate of ectopic pregnancy were higher than those in radical surgery group [68.1％(47/69) vs46.6％(27/58),13.0％(9/69) vs5.2％(3/58)](bothP＜0.05).Conclusion Laparoscopic linear salpingotomy for tubal pregnancy is suitable for patients with fertility requirements with a high intrauterine pregnancy rate after surgery;but the potential risk of ectopic pregnancy is also increased.%目的 探讨腹腔镜下输卵管线形切开术治疗输卵管妊娠对患者预后的影响.方法 选择2015年1月至2016年12月于冀中能源峰峰集团有限公司总医院确诊为输卵管妊娠而接受腹腔镜手术治疗的患者127例.按手术方法不同分为保守手术组(69例)和根治手术组(58例),保守手术组采用腹腔镜下输卵管线形切开术,根治手术组采用腹腔镜下患侧输卵管切除术.观察手术效果,术后随访18个月观察2组患者宫内妊娠率及异位妊娠再发生率.结果 2组患者术中出血量、手术时间、人绒毛膜促性腺激素恢复至正常时间、住院时间、手术成功率比较差异均无统计学意义(均P＞0.05).术后18个月随访,保守手术组患者术后宫内妊娠率和异位妊娠再发生率均高于根治手术组[68.1％(47/69)比46.6％(27/58)、13.0％ (9/69)比5.2％ (3/58)],差异均有统计学意义(均P＜0.05).结论 腹腔镜下输卵管线形切开术治疗输卵管妊娠,术后患者宫内妊娠率高,适用于有生育要求的患者,但是此术式患者术后异位妊娠再发生的潜在风险高于输卵管切除术.