腹腔镜下不同术式治疗输卵管妊娠对再次妊娠的影响

The effect of different types of operations urder laparoscope used in treatment of oviducal pregnancy on re-pregnancy

目的:探讨腹腔镜下不同手术方式治疗输卵管妊娠对再次妊娠的影响。方法:对112例输卵管妊娠病人行腹腔镜下手术治疗(分3组行3种术式进行手术)。A组:腹腔镜下行患侧输卵管线性切开病灶去除术(n=40);B组:腹腔镜下行患侧输卵管线性切开病灶去除后缝合输卵管浆肌层(n=42);C组:腔镜下采用患侧输卵管切除术(n=30)。比较3种术式后有继续生育要求的患者68例术后3～6个月输卵管通畅性;术后2年内异位妊娠发生率;术后2年内再次宫内妊娠成功率的差异。结果:术后3～6个月输卵管通畅性及术后2年再次宫内妊娠成功率:A组与B组比较差异无显著性(P>0.05);A组与C组比较差异具有显著性(P<0.01)。术后2年异位妊娠发生率A组及B组与C组间均无显著差异(P>0.05)。结论:输卵管妊娠行腹腔镜下患侧输卵管线性切开病灶去除术或缝合术可作为希望保留生育功能的输卵管妊娠患者的首选的手术方案,且并不增加再次宫外孕的发生率。

Objective:To investigate the effects on re-pregnancy with different types of operations under laparoscope used in ectopic pregnancy.Methods:112 ectopic pregnant patients were divided randomly into three groups with operation under laparoscope.Group An=40) were performed with laparoscopic salpingostomy.Group B(n=42) were sutured the incision of fallopian tube other than method in group A.Group C(n=30) were performed with laparoscopic salpingostomy.Contrasted the ability of salpinx to unobstruct among three groups within 3 to 6 months after operation,the occurrence rate of ectopic pregnancy 2 years after operation and the re-pregnant rate.Results:There was no obvious difference between group A and group B (P>0.05). The difference between group A and group C was significant (P<0.01).Conclusion:Laparoscopic salpingostomy can be the preferred opearation for those ectopic pregnancy patients with wish to keep reproductive ability,and not increase the occurrence ratio of ectopic pregnancy.