腹腔镜下不同手术方式治疗输卵管妊娠后的妊娠状态

Reproductive outcomes of different laparoscopic operations for ectopic pregnancy

目的探讨腹腔镜下输卵管切除与输卵管开窗取胚两种手术方式对患者妊娠状态的影响。方法回顾性分析2012年1月至12月收治的确诊为输卵管妊娠而接受腹腔镜手术、有生育要求并有随诊条件的127例患者。据手术方式不同分成2组:A组为输卵管切除组(64例),B组为输卵管开窗取胚组(63例)。术后随访2年,比较两组妊娠状态。结果再次异位妊娠率:A组4.7%(3/64),B组15.9%(10/63),两组比较差异有统计学意义(P<0.05)。术后2年宫内妊娠率:A组45.3%(29/64),B组49.2%(31/63),两组比较差异无统计学意义(P>0.05)。结论在输卵管妊娠的腹腔镜手术中,若对侧输卵管外观无异常,建议行患侧输卵管切除术。

Objective To investigate the reproductive outcomes of laparoscopic salpingectomy and salpingotomy after ectopic pregnancy. Methods A total of 127 ectopic pregnant patients were involved during Jan. and Dec. 2012, who wished to preserve reproductive ability. The patients were divided into two groups according to different types of operations. Patients in group A （n = 64） received salpingectomy, while patients in group B （n = 63 ） underwent salpingotomy. The reproductive outcomes after 2 years of follow-up were investigated. Results The recurrent ectopic pregnancy rate was 4.7% （3/64） in group A and 15.9% （10/63） in group B, with significant difference （P 〈 0.05 ）. Intrauterine preg- nancy rate was 45.3 % （29/64） in group A and 49.2% （31/63 ） in group B, with no significant difference （P 〉 0.05 ）. Conclusion If patients with ectopic pregnancy have normal contralateral tubes, we suggest salpingectomy for them.