腹腔镜下输卵管复通术的影响因素分析

Influencing factors of laparoscopic tubal salpingostomy

目的：探讨腹腔镜下输卵管复通术的影响因素。方法：回顾性分析2004年至2010年珠海市妇幼保健院收治的28例行腹腔镜下输卵管复通术患者的临床资料．观察患者年龄、输卵管长度、结扎部位、输卵管周围情况、复通术后输卵管长度及术后妊娠情况。结果：宫内妊娠26例、输卵管妊娠1例、随访5年未受孕l例；术后输卵管长度5-13cm 27例、〈5cm1例；输卵管结扎部位以峡部最多，其次为壶腹部、壶腹-峡部，不同结扎部位患者的宫内妊娠率比较，差异有统计学意义（P〈0．05）；各年龄组患者宫内妊娠率比较．差异无统计学意义（P〉0．05）：输卵管合并炎症与未合并炎症患者宫内妊娠率比较，差异有统计学意义（P〈0．05）。结论：腹腔镜下输卵管复通术后妊娠的影响因素较多，应尽量保留输卵管长度、将不同部位输卵管对合整齐、术后做好防感染等辅助治疗以提高复通效果。

Objective：To determine the influencing factors of laparoscopic tubal salpingostomy. Methods： We retrospectively analyzed the clinical profiles of 28 patients who underwent laparoscopic tubal salpingostomy in Zhuhai Maternal Care and Children＇ s Hospital between 2004 and 2010. This entailed assessment of the age, location of ligation, condition adjacent to the oviduct, the preoperative and postoperative tubal length and the rate of pregnancy postoperatively. Results： After a 5-year follow-up period, there were 26 cases of intrauterine pregnancy and a single case each of tubal pregnancy and pregnancy failure, respectively. The tubal length was 5- 13 cm in 27 cases and 〈 5 cm in a single case. The location of ligation was mostly in the isthmus, followed by the ampulla and the isthmus-ampulla. The rate of pregnancy among all approaches for ligation was statistically different （ P 〈 0.05 ）. The difference in the rate of intrauterine pregnancy was unremarkable in all age groups （ P 〉 0.05）. However, a substantial difference in the rate of pregnancy was found between those with and without inflammation of the oviduct （P 〈 0.05）. Conclusion： There are multiple factors that couhl impact on the rate of pregnancy following laparoscopic tubal salpingostomy. The efficacy could be improved postoperatively by retaining the lenath of oviduct, ligating various portions of the oviduct and Dreventing against infection.