微创手术和传统开腹手术对宫外孕患者受孕率的影响

Effect of minimally invasive surgery and traditional open surgery on pregnancy rate in patients with ectopic pregnancy

目的探讨微创手术和传统开腹手术对宫外孕患者受孕率的影响。方法对2015年1月至2016年12月妇产科收治的120例宫外孕有妊娠需求的患者实施观察,按随机数表法分为微创组(n=60,腹腔镜微创手术)、传统组(n=60,传统开腹手术)。比较两组患者手术状况、手术并发症、术后恢复、性激素水平、术后1年受孕状况。结果微创组的手术时间、术后首次下床活动时间、术后肛门首次排气时间、术后住院时间、血清人绒毛膜促性腺激素水平恢复时间均显著短于传统组,手术出血量显著少于传统组(P<0.05)。微创组患者的手术相关并发症总发生率显著低于传统组,术后1年的宫内妊娠率、总受孕率均显著高于传统组(P<0.05)。两组术后1周、3个月时的雌二醇、促卵泡生成素、促黄体生成素水平均显著低于术前,而术后3个月时显著高于术后1周(P<0.05);微创组术后1周、3个月时的上述指标水平均显著高于传统组(P<0.05)。结论宫外孕患者实施微创手术的术后受孕率高于传统开腹手术,运用价值高。

Objective To investigate the effect of minimally invasive surgery and traditional open surgery on pregnancyrate in patients with ectopic pregnancy. Methods From January 2015 to December 2016, 120 patients with ectopicpregnancy and had pregnancy needs who admitted in the obstetrics and gynecology department were observed. They weredivided into minimally invasive group （n=60, laparoscopic minimally invasive surgery） and conventional group （n=60,traditional open surgery） according to the random number table method. The surgical status, surgical complications,postoperative recovery, sex hormone levels, and 1-year postoperative pregnancy status were compared between the twogroups. Results The operation time, first time to get out of bed after surgery, postoperative anal first exhaust time,postoperative hospital stay, and recovery time of serum human chorionic gonadotropin levels in the minimally invasivegroup were significantly shorter than those in the conventional group, and the amount of surgical bleeding was significantlyless than that of the conventional group （P〈0.05）. The total incidence of surgery-related complications in the minimallyinvasive group was significantly lower than that in the conventional group, the intrauterine pregnancy rate and totalconception rate at 1 year after surgery were significantly higher than those in the conventional group（P〈0.05）. The levels ofestradiol, follicle stimulating hormone and luteinizing hormone in the two groups at 1 week and 3 months after surgery weresignificantly lower than those before surgery, and those at 3 months after surgery were significantly higher than 1 week aftersurgery （P〈0.05）; the levels of the above indicators at 1 week and 3 months after surgery in the minimally invasive groupwere significantly higher than those in the conventional group （P〈0.05）. Conclusion The postoperative pregnancy rate of patients with ectopic pregnancy who performed minimally invasive surgery is higher than that of traditional open surgery,with high applying value.