微创输卵管开窗取胚术对异位妊娠患者的手术效果及β-hCG水平、再妊娠率的影响

Effects of Minimally Invasive Oviduct Fenestration for Embryo Extraction on the Surgical Effect,β-hCG Level and Repregnancy Rate of Ectopic Pregnancy Patients

目的:探讨微创输卵管开窗取胚术对异位妊娠患者的治疗手术效果及β-人绒毛膜促性腺激素(β-hCG)、再妊娠率的影响。方法:选取2018年1月-2019年1月本院收治的96例异位妊娠患者的临床资料进行回顾性分析,将其随机分为观察组与对照组,各48例。观察组给予微创输卵管开窗取胚术治疗,对照组给予输卵管切除术治疗。比较两组手术相关指标、并发症发生情况;比较两组术前及术后第1、5、10、15天的β-hCG水平。随访18个月,比较两组随访期间输卵管通畅率、受精成功率、宫内再妊娠率。结果:观察组手术时间、术中失血量、术后引流量及住院时间均低于对照组(P<0.05)。观察组并发症发生率为8.33%(4/48),低于对照组的25.00%(12/48)(P<0.05)。观察组术后第1、5、10、15天的β-hCG水平均低于对照组(P<0.05)。随访18个月,观察组输卵管通畅率、受精成功率、宫内再妊娠率均高于对照组(P<0.05)。结论:微创输卵管开窗取胚术治疗异位妊娠患者效果显著,能够降低手术损伤,提高手术安全性,可有效降低血清β-hCG水平,维持患者正常的解剖结构和保留患者的生育能力,提高患者宫内再妊娠率。

Objective:To investigate the effect of minimally invasive oviduct fenestration for embryo extraction on the treatment of ectopic pregnancy,β-human chorionic gonadotropin (β-hCG) and the repregnancy rate.Method:The clinical data of 96 patients with ectopic pregnancy admitted to our hospital from January 2018 to January 2019 were retrospectively analyzed,and they were randomly divided into observation group and control group,with 48 cases in each group.The observation group was treated with minimally invasive oviduct fenestration for embryo extraction,and the control group was treated with salpingectomy.Surgery related indicators and complications were compared between the two groups.The levels of β-hCG before surgery and on day 1,5,10 and 15 after surgery were compared between the two groups.The tubal patencies,fertilization success rate and intrauterine repregnancy rate were compared between the two groups during the follow-up period of 18 months.Result:The operation time,intraoperative blood loss,postoperative drainage volume and hospital stay in the observation group were lower than those in the control group (P<0.05).The incidence of complications in the observation group was 8.33%(4/48),which was lower than 25.00%(12/48) in the control group (P<0.05).The levels of β-hCG in observation group were lower than those in control group on day 1,5,10 and 15 after surgery (P<0.05).Followed up for 18 months,The tubal patently rate,fertilization success rate and intrauterine repregnancy rate in the observation group were all higher than those in the control group (P<0.05).Conclusion:Minimally invasive oviduct fenestration for embryo extraction has a significant effect in the treatment of ectopic pregnancy patients.It can reduce surgical injury,improve surgical safety,effectively reduce the level of serum β-hCG,maintain the normal anatomical structure of patients and retain the fertility of patients,and improve the rate of intrauterine pregnancy.