宫外孕保守治疗和手术切除输卵管对女性性功能的影响对比分析

Comparative analysis of the effect of conservative treatment and surgical removal of fallopian tube on female sexual function in ectopic pregnancy

目的:对比分析宫外孕保守治疗和手术切除输卵管对女性性功能的影响,为宫外孕患者治疗方案的选择提供参考。方法:选择2013年6月至2016年6月我院收治的118例宫外孕患者作为研究对象,根据患者所采用的治疗方案的不同,将其分为保守治疗组(56例)和手术治疗组(62例)。比较两组患者完成治疗2个月、4个月、6个月后雌激素(E_2)、孕酮(P)、睾酮(T)、卵巢功能评分及女性性功能指数(Female Sexual Function Index,FSFI)变化,分析不同治疗方案对宫外孕患者的性功能的影响。结果:两组患者年龄、孕次、就诊时FSFI指数比较差异无统计学意义(P<0.05)。完成治疗后2、4、6个月,两组患者E_2、P、T较治疗前明显降低(P<0.05);而组间上述指标比较无统计学差异(P>0.05)。治疗后2个月两组患者的卵巢功能评分、FSFI评分与治疗前比较均有不同程度的下降(P<0.05);治疗后4个月、6个月逐渐恢复,且保守组患者卵巢功能评分明显低于手术组患者,FSFI评分明显高于手术组(P<0.05)。结论:宫外孕手术切除输卵管对女性卵巢功能和性功能指数有一定的影响,可能与手术对患者的性心理造成一定的负面影响有关,临床选择宫外孕治疗方案时应酌情考虑此因素。

Objectives： To compare the effects of conservative treatment and surgical removal of fallopian tube on female sexual function in ectopic pregnancy,so as to provide reference for the selection of treatment options for ectopic pregnancy patients. Methods： 118 patients with ectopic pregnancy from June 2013 to June 2016 year in our hospital were selected as the research object. According to the treatment method,they were divided into conservative treatment group（ 56 cases） and operative treatment group（ 62 cases）. Estrogen（ E2） and progesterone（P）,testosterone（T）,ovarian function score and female sexual function index（FSFI） changes of two groups at 2 months,4 months and 6 months after the treatment were compared. The influence of different treatment for patients was analyzed. Results： There was no significant difference in the aspects of age,gravidity and FSFI between the two groups. At the 2,4 and 6 months after treatment,E2,P and T levels of two groups were significantly lower than these before treatment（ P 0. 05）,while there was no statistical difference between the two groups（ P 0. 05）. At2 months after the treatment,the ovarian function score and female sexual function index of two groups had different degree of decrease（ P 0. 05）. At 4 months and 6 months after treatment,ovarian function score of conservative group was significantly lower than that of operation group and FSFI score of conservative group was significantly higher than that of operation group（ P 0. 05）. Conclusion： Surgical removal of fallopian tube in ectopic pregnancy has certain influence on ovarian function and sexual function index,which may be caused by the negative psychological impact. Clinical treatment of ectopic pregnancy should be appropriate to consider this factor.