腹腔镜输卵管切开取胚术后输卵管通畅率及其影响因素分析

Patency rate and its related factors after laparoscopic salpingotomy and embryo removal

目的：分析腹腔镜下输卵管切开取胚术对保留输卵管功能的价值、术后输卵管通畅率及其影响因素。方法：选取2012年1月至2012年12月行腹腔镜下输卵管切开取胚术的86例输卵管妊娠患者，于术后第3次月经干净后3～7d行子宫输卵管碘油造影，观察其输卵管通畅程度。结果：输卵管壶腹部妊娠术后输卵管通畅率明显高于峡部妊娠患者；术中出血量大于50ml的患者，输卵管通畅率明显降低；存在严重盆腔炎榆卵管周围炎性粘连的患者，其输卵管通畅率亦明显降低。结论：腹腔镜下输卵管切开取胚术后输卵管通畅率与输卵管妊娠部位、术中出血量、操作方式及盆腔粘连程度有关。腹腔镜下输卵管切开取胚术是有生育要求的输卵管妊娠患者的理想治疗方法，术后应注意防止持续性异位妊娠。

Objective： To analyze the value of laparoscopic salpingotomy and embryo removal for reservation of tubal function, postoperative tubal patency rate and related factors. Methods ： A consecutive series of 86 patients with salpingocyesis underwent laparo- scopic salpingotomy and embryo removal between Jan. 2012 and Dec. 2012. The tubal patency rates were observed by hysterosalpingog- raphy during 3-7 d after the third postoperative menstruation was clean. Results：Ampullary pregnancy had a higher postoperative paten- cy rate compared with isthmic pregnancy, patients whose blood loss in the surgery was more than 50 ml had obviously lower patency rate. Patients with severe pelvic inflammation and adhesions around oviduct also had lower patency rate. Conclusions：Patency rate after laparoscopic salpingotomy and embryo removal is related to the site of salpingocyesis, blood loss, operation method and pelvic adhesion. Laparoscopic salpingotomy and embryo removal is the ideal treatment for patients with salpingocyesis who has the desire for fertility, and attention should be paid to prevent postoperative persistent salpingocyesis.