腹腔镜下输卵管开窗术治疗对输卵管妊娠患者卵巢功能及预后的影响

Effect of laparoscopic fenestration of fallopian tube on ovarian function and prognosis of tubal pregnancy

目的:探讨腹腔镜下输卵管开窗术治疗对输卵管妊娠患者卵巢功能及预后的影响。方法:回顾性收集我院2017年6月至2021年6月收治的76例输卵管妊娠患者的临床资料。按照手术方式不同将患者分为对照组(行腹腔镜下输卵管切除术治疗,35例)和观察组(行腹腔镜下输卵管开窗取胚术治疗,41例)。分析对比两组手术的激素指标、手术情况、术后输卵管的通畅情况以及妊娠情况。结果:术后,两组的血清促卵泡生成素(Follicle-stimulating hormone,FSH)指标水平均降低,血清雌二醇(Estrogen,E2)、黄体生成素(Luteinizing Hormone,LHA)指标水平均升高,且观察组FSH指标水平较对照组明显降低,E2、LH指标水平较观察组明显升高(P<0.05)。两组的手术时间、术后排气时间、住院时间均无显著差异。观察组的出血量明显少于对照组(P<0.05)。两组的术后输卵管通畅情况比较无显著差异。术后随访中,观察组宫内妊娠率明显高于对照组(P<0.05)。结论:在治疗输卵管妊娠中,腹腔镜下行输卵管开窗术可改善卵巢功能,提高患者宫内妊娠率。

Objective:To investigate the effect of laparoscopic fenestration of fallopian tube on ovarian function and prognosis of tubal pregnancy.Methods:The clinical data of 76 patients with tubal pregnancy admitted to our hospital from June 2017 to June 2021 were retrospectively collected.Patients were divided into control group(laparoscopic salpingectomy,35 cases)and observation group(laparoscopic fallopian tube fenestration,41 cases)according to different surgical procedures.The hormone indexes,operation conditions,patency of fallopian tube and pregnancy of the two groups were analyzed and compared.Results:After operation,serum FSH index levels were decreased in both groups,and serum E2 and LH index levels were increased in both groups.FSH index levels in observation group were significantly decreased compared with control group,and E2 and LH index levels were significantly increased compared with observation group(P<0.05).There were no significant differences in operation time,postoperative exhaust time and hospital stay between the two groups、.The blood loss in the observation group was significantly lower than that in the control group(P<0.05).There was no significant difference in fallopian tube patency between the two groups.During postoperative follow-up,the intrauterine pregnancy rate in the observation group was significantly higher than that in the control group(P<0.05).Conclusion:In the treatment of tubal pregnancy,laparoscopic tubal fenestration can improve ovarian function and increase the rate of intrauterine pregnancy.