未破裂型输卵管妊娠部分输卵管切除并吻合临床研究

Fallopian tube recanalization in tubal pregnancy patients

目的 探讨未破裂型输卵管妊娠患者行输卵管妊娠部切除并吻合术的可行性及疗效.方法 27例有生育要求的未破裂型输卵管妊娠患者,行输卵管妊娠部切除并吻合术（吻合组）,30例输卵管妊娠切开取胚（切开组）.比较两组患者手术疗效,随访6个月～5年观察两组输卵管通畅率及妊娠率.结果 术后血β-HCG、手术时间、术中出血量、住院时间吻合组分别为（2.3±1.5）IU/L、（60.0±5.5）min、（45.2±5.7）ml和（6.0±1.2） d;切开组分别为（2.6±1.8）IU/L、（53.3±6.3） min、（50.3±5.5）ml和（6.0±2.1）d,差异均无统计学意义;吻合组输卵管吻合通畅率和宫内妊娠比例分别为92.6 %（25/27）和92.6 %（25/27）.切开组输卵管造口的通畅率和宫内妊娠率分别为76.7 %（23/30）和66.7 %（20/30）,吻合组输卵管通畅率和宫内妊娠率均高于切开组,差异有统计学意义.结论 异位妊娠有生育要求,未破裂型输卵管妊娠患者,输卵管妊娠部切除并吻合安全性好,远期效果优于输卵管切开取胚.

Objective To study the feasibility and effect of fallopian tube recanalization in tubal pregnancy. Methods 27 patients who have tubal pregnancy and fallopian tube recanalization as observer group, 30 patients who were salpingotomies as control group , these patients come from our hospital in January, 2005 to May, 2011. the value of HCG in blood in both groups are more than 2000 mIU/ml, affixical mass is less than 30 mm. Compare the effect in intraoperation and postoperation. Results The decline of β-HCG are same, the time of operation, amount of bleeding, postoperation temperature and hospital stays are same. The rate of pregnancy are different. They are 92.6 % and 66. 7 % in the observer group and control group：during six mouthes to five years follow up clinic, the patency rate with fallopian tube recanalization was 92.6 %, and the intrauterine pregnancy rate was 92.6 % in observation group, the pateney rate with fallopian was 76. 7 %, and the intrauterine pregnancy rate was 66.7% in control group： there were statistical difference between two groups. Conclusion Fallopian tube recanalization is safe and effective. Long term result is better than salpingotomy.