宫外孕患者采用腹腔镜保守手术治疗后对有生育意愿者受孕率的影响

Effect of laparoscopic conservative surgery on the postoperative pregnancy rate in patients with ectopic pregnancy

目的观察宫外孕患者采用腹腔镜保守手术治疗后对有生育意愿患者受孕率的影响,为宫外孕的治疗提供参考依据。方法选取2016年1月至2017年12月单县东大医院诊治的92例有生育意愿且无其他不孕因素的宫外孕患者作为研究对象。根据手术方式分为两组,43例采用腹腔镜保守手术治疗的患者设为腔镜组,采用开腹手术治疗的49例患者设为开腹组,患者术后均随访12个月,比较两组术后输卵管通畅率、受孕率和并发症发生率。结果腔镜组输卵管通畅率为79.07%,宫内妊娠率为55.81%,明显高于开腹组的59.18%、26.53%,差异具有统计学意义(P<0.05)。两组再次异位妊娠率差异无统计学意义(P>0.05)。腔镜组腹痛、感染等并发症发生率为6.98%,明显低于开腹组的22.45%,差异具有统计学意义(P<0.05)。结论宫外孕患者采用腹腔镜保守手术治疗可提高输卵管通畅率,从而提高术后再受孕率,并可减少术后并发症发生率。

Objective To observe the effect of laparoscopic conservative surgery on the postoperative pregnancy rate in patients with ectopic pregnancy, in order to provide reference for the treatment of ectopic pregnancy. Methods 92 patients diagnosed with ectopic pregnancy and received laparoscopic conservative surgery in our hospital from January 2016 to December 2017 were selected. All had fertility needs without other infertility factors. Based on the operation methods chosen, they were divided into the laparoscopic group(n=43) and the open surgery group(n=49). All the patients were followed up for 12 months after surgery, and the postoperative tubal patency rate, intrauterine pregnancy rate and incidence of complications were compared. Results The tubal patency rate and intrauterine pregnancy rate of the laparoscopic group was 79.07% and 55.81% respectively, which were significantly higher than those of the open surgery group(59.18% and 26.53%), with statistically significant differences(P<0.05). There was no statistically significant difference in the rate of ectopic pregnancy after treatment between the two groups(P>0.05). The incidence of abdominal pain, infection and other complications in the laparoscopic group(6.98%) was significantly lower than that in the open surgery group(22.45%), with statistically significant differences(P<0.05). Conclusions Laparoscopic conservative surgery for ectopic pregnancy can improve the tubal patency rate and postoperative pregnancy rate, and reduce the incidence of postoperative complications.