腹腔镜不同术式对输卵管妊娠患者术后生殖能力的影响

The effects of different laparoscopic surgeries on reproductive ability in patients with tubal pregnancy

目的对腹腔镜下输卵管妊娠手术不同术式对输卵管妊娠患者术后生育的影响进行比较。方法回顾性分析2015年1月至2015年12月于本院接受腹腔镜下输卵管妊娠手术(开窗取胚术或输卵管切除术)且具有再生育要求的126例输卵管妊娠患者的临床资料,将患者分为两组,即"开窗取胚术"组(组1)和"输卵管切除术"组(组2),了解各组患者在术后2年随访期内的妊娠情况,并对各组的术后宫内妊娠发生率及术后再次异位妊娠发生率进行计算。结果组1有57例患者,其中2例失访。组2有69例患者,其中7例失访。组1和组2的术后宫内妊娠发生率分别为57.2%(28/49)和61.0%(36/59),术后再次异位妊娠发生率则分别为36.7%(18/49)和16.9%(10/59)。在术后宫内妊娠发生率方面,两组间差异无统计学意义,组1的术后再次异位妊娠发生率明显高于组2(P<0.05)。结论开窗取胚术与输卵管切除术这两种术式具有相似的影响术后宫内妊娠的效果,但前者较之后者更易导致术后再次异位妊娠的产生。

Objective To compare the effects of different laparoscopic surgeries for tubal pregnancy on reproductive ability in patients with tubal pregnancy. Methods Retrospective analysis method was employed to analyze the clinical data from 126 cases of patients with tubal pregnancy, who received different types of laparoscopic surgeries for tubal pregnancy in our hospital in 2015 and had post-surgery re-reproducing will. The patients were divided into two groups, conservative surgical treatment group(group 1) and radical surgical treatment group(group 2), and their fertilities following surgical treatment were observed during a 2-year follow-up period. Results There were 57 cases of patients in group 1, two of which were lost to follow up. In group 1, the incidence of intra-uterine pregnancy and that of ectopic pregnancy following surgical treatment were 57.2%(28/49)and 36.7%(18/49), respectively. On the other hand, there were 69 cases of patients in group 2, seven of which were lost to follow up. In group 2, the incidence of intra-uterine pregnancy and that of ectopic pregnancy following surgical treatment were 61.0%(36/59) and 16.9%(10/59), respectively.In terms of the incidence of intra-uterine pregnancy following surgical treatment, there was no difference between group 1 and group 2. However, the incidence of ectopic pregnancy following surgical treatment in group 1 was significantly higher than that in group 2(P<0.05). Conclusion Conservative surgical treatment and radical surgical treatment for tubal pregnancy have similar effects on the intra-uterine pregnancy following surgical treatment. Nevertheless, conservative surgical treatment is more likely to induce ectopic pregnancy when compared with radical surgical treatment.