输卵管开窗术与患侧输卵管切除术治疗输卵管妊娠的效果比较

Effect comparison of oviduct fenestration and salpingectomy in affected side in the treatment of tubal gestation

目的研究针对输卵管妊娠患者分别采用腹腔镜下输卵管开窗术和患侧输卵管切除术后对患者生育功能的影响。方法 2010年1月~2013年1月于我院行腹腔镜保留生育功能术式治疗的147例输卵管妊娠患者,按照术式不同分为观察组74例和对照组73例,观察组采用输卵管开窗术,对照组采用患侧输卵管切除术,观察两组手术情况和术后2年妊娠情况。结果两组手术时间、术中出血量比较差异无统计学意义（P〉0.05）;观察组术后2年异位妊娠率为5.4%,略高于对照组（4.1%）,两组比较差异无统计学意义（P〉0.05）。观察组术后2年宫内妊娠率为68.9%,高于对照组（56.2%）,两组比较差异有统计学意义（P〈0.05）。结论针对输卵管妊娠患者采用腹腔镜下输卵管开窗术,术后宫内妊娠率较高,在保留术后生育功能方面的效果较佳。

Objective To study the influence of laparoscopic oviduct fenestration and salpingectomy in affected side on reproductive function in tubal gestation patients. Methods From January 2010 to January 2013,147 tubal gestation patients undergone laparoscopy for fertility-preserving were divided into observation group （n=74） and control group （n= 73） based on different surgical methods.In the observation group,oviduct fenestration was adopted,while in the control group,salpingectomy in affected side was used.The surgical condition and postoperative pregnancy after 2 years in both groups were observed. Results There was no difference in operative time or intraoperative amount of bleeding （P〉0.05）. With regard to ectopic pregnancy rate,the rate in the observation group was 5.4%, which was slightly higher than that in the control group accounting for 4.1%,but there was no obvious difference （P〉0.05）.In the observation group,2-year postoperative intrauterine pregnancy rate was 68.9%, which was higher than that in the control group of 56.2%,which displayed a statistical difference （P〈0.05）. Conclusion For patients with tubal gestation,application of laparoscopic oviduct fenestration obtains a higher postoperative intrauterine pregnancy rate and optimal effect on fertility-preserving after surgery.