输卵管妊娠应用腹腔镜3种保守手术治疗后的妊娠结局比较

Comparison of Pregnancy Outcome after Three Types of Laparoscopic Conservative Treatment for Tubal Pregnancy

目的:比较3种腹腔镜保守手术治疗输卵管妊娠患者术后的妊娠结局。方法:初次、未破裂输卵管妊娠且有生育要求的患者268例,均符合腹腔镜保守治疗标准并能够配合随访,腹腔镜下保守手术术式包括输卵管切开取胚术(n=147)、修补术(n=85)和挤压术(n=36),术后随访2年,比较输卵管通畅率及妊娠率。结果:应用输卵管修补术后患侧输卵管通畅率和妊娠率均显著高于切开取胚术及挤压术(P<0.05)。结论:对于合适的输卵管妊娠者应用输卵管修补术治疗能够保留患侧输卵管并获得较好的妊娠结局。

Objective： To compare pregnancy outcome after three types of laparoscopic conservative treatment for tubal pregnancy.Methods： A total of 268 patients with nonruptured tubal pregnancy who had no history of tubal pregnancy and desired future pregnancy were enrolled into this study.All patients met the criteria of laparoscopic conservative treatment.These cases were assigned to undergo laparoscopic conservative salpingotomy without sutur-ing（n=147）,salpingotomy with suturing（n=85） or fimbrial evacuation（n=36）,respectively.Within 2 years after laparoscopic conservative treatment,the follow-up was performed to compare tubal patency rate and pregnancy rate.Results： Laparoscopic conservative salpingotomy with suturing had the highest tubal patency rate and pregnancy rate among three types of laparoscopic conservative treatment for tubal pregnancy（P0.05）.Conclusion： Suitable laparoscopic conservative treatment should be chosen to treat patients of tubal pregnancy who desire future pregnancy,which could remain ill fallopian tube and obtain better pregnancy outcome.