阴道四维输卵管超声造影术在评价输卵管妊娠经不同治疗方式后输卵管通畅性中的价值

摘要

目的：探讨阴道四维输卵管超声造影术在评价输卵管妊娠经不同的保留输卵管治疗方式后输卵管通畅性中的应用价值。方法选取本院2012年3月~2014年3月收治的输卵管妊娠患者，按治疗方式分为期待疗法组、药物保守治疗组、介入性治疗组、腹腔镜保守手术治疗组，每组30例。输卵管妊娠治疗结束后3~6个月，所有患者进行阴道四维输卵管超声造影术并记录患侧及对侧输卵管通畅性的情况以及宫内妊娠结果，探讨输卵管妊娠不同的治疗方式对输卵管通畅性的影响，再与宫内妊娠结果对比。结果期待疗法组、药物治疗组与腹腔镜保守手术治疗组患侧输卵管通畅率比较，差异有统计学意义（P<0.05）；期待疗法组、药物治疗组与腹腔镜保守手术治疗组双侧输卵管通畅率比较，差异有统计学意义（P<0.05）；其余各组间比较，差异无统计学意义（P>0.05）。腹腔镜保守手术治疗组的宫内妊娠率明显高于期待疗法组、药物治疗组、介入治疗，但各组间差异无统计学意义（P>0.05）。结论腹腔镜保守手术治疗输卵管妊娠可使输卵管功能恢复最佳。阴道四维输卵管超声造影可简单、无创、高效地评价输卵管妊娠治疗后输卵管功能的恢复情况及治疗效果，进而预测宫内妊娠、再次异位妊娠的发生率，具有很高的经济及社会价值，值得临床推广应用。%Objective To explore the application value of tubal patency by different therapeutic methods in fallopian pregnancy evaluated by vaginal four-dimensional ultrasonography of fallopian tube. Methods Patients with fallopian pregnancy treated in our hospital from March 2012 to March 2014 were selected,and were divided into expectant treat-ment group,conservative drug therapy group,interventional treatment group,and laparoscopic conservative surgery group according to different treatment methods,each group with 30 cases.Patients were examined by vaginal four-dimensional ultrasonography of fallopian tube 3-6 months after finishing tubal pregnancy treatment.The tubal patency in affected and opposite sides were both recorded,the influence on tubal patency by different therapeutic methods in fallopian pregnancy was explored,which was compared with that in uterine pregnancy. Results There was statistical difference in patency rate of affected side and bilateral sides of fallopian tube between conservative drug therapy group and laparo-scopic conservative surgery group,and between expectant treatment group and laparoscopic conservative surgery group (P<0.05).Intrauterine pregnancy rate of laparoscopic conservative surgery group was higher than that of the other three groups,but the difference was not significant (P>0.05). Conclusion Functional recovery of fallopian tube is best in la-paroscopic conservative surgery group.Vaginal four-dimensional ultrasonography of fallopian tube can simply,non-inva-sively,and effectively evaluate functional recovery of fallopian tube after treatment of tubal pregnancy,and then predict the incidence of uterine pregnancy,which is worthy of application and promotion in clinic.