腹腔镜下不同手术方式对输卵管妊娠患者妊娠结局的影响

Influence of Different Laparoscope-guided Surgeries on Pregnant Outcomes of Patients with Salpingocyesis

目的比较腹腔镜下输卵管切除术与输卵管切开取胚术对输卵管妊娠患者妊娠结局的影响。方法根据手术方式的不同,将94例输卵管妊娠患者分为切除组45例(行输卵管切除术)和取胚组49例(行输卵管切开取胚术),比较两组手术时间、术中出血量、住院天数,观察术后两年内再次异位妊娠及宫内妊娠情况。结果与取胚组比较,切除组术中出血量明显减少,手术时间、住院天数明显缩短,差异有统计学意义(P<0.01)。切除组术后两年内再次异位妊娠率为4.44%,显著低于取胚组的18.37%,差异有统计学意义(P<0.05);切除组宫内妊娠率为55.56%,取胚组为61.22%,两组比较差异无统计学意义(P>0.05)。结论腹腔镜下输卵管切除术可有效降低输卵管妊娠患者的再次异位妊娠率,但对宫内妊娠无明显影响。

OBJECTIVE To compare the influence of laparoscope-guided salpingectomy and salpingotomy for embryo collection on preg- nant outcomes of patients with salpingocyesis. METHODS A total of 94 patients with salpingocyesis were divided into resection group （n=45） treated with laparoscope-guided salpingectomy and embryo-collecting group （n=49） with laparoscope-guided salpingotomy based on different surgeries. Surgical duration, intra-operative hemorrhagic volume, and hospital stays were compared between two groups, and postoperative re-ectopic pregnancy and intrauterine pregnancy were observed. RESULTS Compared with embryo-collect- ing group, resection group were markedly less in intra-operative hemorrhagic volume and notably shorter in surgical duration and hospital stay （P〈0.01）. The rate of re-ectopic pregnancy within postoperative 2 years was 4.44% in resection group, evidently low- er than the 18.37% in embryo-collecting group （P.〈0.05）. Meanwhile, the rate of intrauterine pregnancy was 55.56% in resection group, lower than the 61.22% in embryo-collecting group, but there was insignificant difference（P〉0.05）. CONCLUSION Laparo- scope-guided salpingectomy can effectively reduce the rate of re-ectopic pregnancy without influencing intrauterine pregnancy in pa- tients with salpingocyesis.