输卵管部分切除对再次妊娠的影响

Impact of Partial Resection of Fallopian Tubal on Re-pregnancy

目的探讨输卵管妊娠治疗中输卵管部分切除与否对再次妊娠的影响。方法将115例有生育要求的输卵管妊娠患者按治疗方法的不同分为药物组(A组)、切除组(B组)和保留组(C组),分别行药物杀胚、输卵管切除及输卵管保留手术治疗,随访2年,对三组患者的临床资料进行回顾性分析,比较三组患者的输卵管通畅率、宫内再次妊娠率、重复输卵管妊娠率以及继发不孕的发生率。结果三组患者均于治愈后第3个月进行子宫输卵管碘油造影,输卵管通畅率以C组最高,显著高于A组和B组,差异有统计学意义(P<0.05),但A组和B组间比较差异无统计学意义(P>0.05);宫内妊娠率以C组最高,显著高于A组和B组,差异有统计学意义(P<0.05),但A组和B组间比较差异无统计学意义(P>0.05);继发不孕率以C组最低,显著低于A组和B组,差异有统计学意义(P<0.05),但A组和B组间比较差异无统计学意义(P>0.05);三组之间重复输卵管妊娠率比较差异无统计学意义(P>0.05)。结论输卵管妊娠行腹腔镜下保守性手术是对希望保留生育功能患者的首选治疗方式,且不增加重复输卵管妊娠的发生率。

Objective To investigate the impact of partial resection of fallopian tubal tubal on re-pregnancy. Methods All 115 patients of fallopian tubal pregnancy with fertility requirements were divided into treatment group （Group A）,resection group （Group B） and retention group （Group C） based on different therapy methods,receiving drugs to kill embryos,salpingectomy and tubal retention surgery,respectively and were followed up for 2 years,the patients of the three groups were retrospectively analyzed to compare the tubal pregnancy rate,intrauterine repregnancy rate,repeat tubal pregnancy and the incidence of secondary infertility. Results The patients of the three groups all received hysterosalpingography in the third month after their cure,and the tubal pregnancy rate of Group C was the highest, significantly higher than that of Groups A and B, with a significant difference （P〈0.05） but no significant difference between Groups A and B （P〉0.05）. The intrauterine pregnancy rate of Group C was the highest,significantly higher than that of Groups A and B,with a significant difference（P〈0.05） but no significant difference between Groups A and B（P〉0.05）. The secondary infertility rate of Group C was the lowest,significantly lower than that of Groups A and B,with a significant difference （P〈0.05）but no significant difference between Groups A and B （P〉0.05）. There was no significant difference in the repeat tubal pregnancy rate between the three groups（P〉0.05）. Conclusion The conservative operation is the first choice for the patients with tubal pregnancy who wish to preserve the pregnancy ability, without an increase in the repeat ectopic pregnancy rate.