腹腔镜下输卵管伞端不同造口方式对输卵管积液患者的妊娠结局影响

The effect of different surgical methods of salpingostomy under laparoscopy on pregnant outcome in patients with oviduct effusion

目的探讨输卵管积液患者腹腔镜下输卵管伞端不同造口方式对妊娠结局的影响。方法选取我院2013年1月至2015年4月因输卵管积液致不孕患者68例,均入院行腹腔镜下输卵管造口术,按随机数字表法分为两组,缝合组采用伞端缝合成型,电凝组采用伞端双极电凝成型。对比两组的手术时间、术中出血量、术后肛门恢复排气时间、术后住院天数及术后输卵管情况;术后随访3年,比较两组输卵管积液复发率、自然受孕率、异位妊娠率、流产率、足月分娩率情况。结果两组患者手术时间、术中出血量、术后肛门开始排气时间、住院天数及输卵管分级差异无统计学意义(P>0.05);缝合组自然受孕率明显高于电凝组(P<0.05);输卵管积液复发明显低于电凝组(P<0.05);两组异位妊娠率、流产率及足月分娩率差异无统计学意义(P>0.05)。结论腹腔镜下输卵管造口后缝合成型术较双极电凝成型术后自然受孕率高,输卵管积液复发率低,方法简便易行,值得推广。

Objective To investigate the effect of different salpingostomy methods on the pregnancy outcome of patients with oviduct effusion.Methods Sixty-eight infertility patients caused by oviduct effusion were treated with salpingostomy in our hospital from January 2013 to April 2015.The patients were randomly divided into suture group and electrocoagulation group,34 in each group.The suture group was composed of suture of fimbriated extremity of fallopian molding, and the electrocoagulation group was treated with fimbriated extremity of fallopian bipolar coagulation.The operative time, intraoperative blood loss, postoperative anal recovery time, post-operative hospital stay and postoperative tubal grading were compared between the two groups.After 3 years of follow-up, the recurrence rate of oviduct effusion, natural pregnancy rate, ectopic pregnancy rate, abortion rate and full term delivery rate were compared between the two groups.Results There was no significant difference in the operation time, intraoperative bleeding, postoperative anus recovery, postoperative hospital days and postoperative tubal grading between the two groups （ P 〉0.05 ） . The natural pregnancy rate of the suture group was significantly higher than that of the electrocoagulation group （ P 〈0.05 ） .The recurrence of oviduct fluid in the suture group was significantly lower than that of the electrocoagulation group （ P 〈0.05 ）.However, there was no significant difference in the ectopic pregnancy rate,abortion rate,preterm birth rate and pregnancy delivery rate between the two groups （P〉0.05）. Conclusion Suture after salpingostomy under laparoscopy is higher in natural pregnancy rate than that of bipolar electrocoagulation.The recurrence rate of oviduct effusion is low.It is simple and easy to use.It is of worthy for popularizing.