输卵管妊娠保留输卵管功能术后的量化评估

QUANTITATIVE ASSESSMENT OF TUBAL FUNCTION AFTER LAPAROSCOPIC CONSERVATIVE SURGERY FOR TUBAL PREGNANCY

目的探讨腹腔镜下输卵管妊娠保留输卵管功能术后进行量化评估的意义。方法对在腹腔镜下行保留输卵管功能手术治疗的101例输卵管妊娠患者术后行宫腔镜下输卵管插管通液术,并同时测定输卵管压力,术后1年随访妊娠率。结果不同部位输卵管妊娠保留输卵管功能术后患侧输卵管压力存在显著差异,壶腹部妊娠为(16.3±4.5)kPa,峡部妊娠为(23.4±2.1)kPa。术后宫内妊娠率与输卵管压力相关,输卵管内压力<15kPa组术后宫内妊娠率与输卵管压力16～20kPa组间比较宫内妊娠率差异无统计学意义(P>0.05),输卵管内压力>21kPa组宫内妊娠率明显低于压力<20kPa组,差异有统计学意义(P<0.05)。不同部位输卵管妊娠术后宫内妊娠率比较差异无统计学意义(P>0.05)。结论输卵管妊娠保留输卵管功能术后功能恢复与输卵管妊娠部位有关;宫内妊娠率与输卵管压力相关。

Objective To analyse the significance of quantitative assessment of tubal function after laparoscopic conservative surgery for tubal pregnancy. Methods One hundred and one cases of tubal pregnancy received laparoscopic conservative surgery. Tubal pressure was measured when tubal catheterization and hydrotubation were performed using hysteroscopy postoperatively. The rates of pregnancy were observed. Results A significant difference was found in the tubal pressure between ampulla pregnancy and isthmus pregnancy groups. The rate of intrauterine pregnancy was related to the tube pressure. The pregnancy rate of patients with tubal pressure greater than 21 KPa was significantly lower than those with pressure less than 20kPa （ P 〈 0.05 ）. There was no statistical difference in pregnancy rate after ampulla and isthmus pregnancy. Conclusion The recovery of tubal function after conservative surgery for tubal pregnancy is related to the site and the rate of intrauterine pregnancy is related to the tubal pressure.