腹腔镜下保留及切除输卵管在输卵管妊娠中的应用效果比较

Comparison of the application effect of laparoscopic tubal retention and resection in tubal pregnancy

目的比较分析在输卵管妊娠中实施腹腔镜下保留输卵管、切除输卵管治疗的临床效果。方法回顾性选择2018年1月至2020年12月在滨州医学院附属医院就诊的128例输卵管妊娠患者作为研究对象,按照腹腔镜下是否保留输卵管分为观察组(n=64)和对照组(n=64)。观察组接受腹腔镜下保留输卵管治疗,对照组接受腹腔镜下切除输卵管治疗。比较两组治疗成功率、临床指标、随访妊娠结局及人绒毛膜促性腺激素(β-HCG)水平变化情况。结果两组在治疗成功率比较,差异无统计学意义(P>0.05)。观察组手术用时及术中出血量高于对照组,差异有统计学意义(P<0.05);两组血清β-HCG恢复至正常时间及术后住院时间比较,差异无统计学意义(P>0.05);术前两组β-HCG水平比较,差异无统计学意义(P>0.05);观察组术后3、7 d,β-HCG水平高于对照组,差异有统计学意义(P<0.05);观察组术后3、7 dβ-HCG降低率低于对照组,差异有统计学意义(P<0.05)。观察组正常妊娠率高于对照组,差异有统计学意义(P<0.05)。结论在输卵管妊娠中,腹腔镜下保留、切除输卵管均具有较高的治疗成功率,切除输卵管在手术时间、术中出血及术后β-HCG降低均优于保留输卵管;但保留输卵管术后正常妊娠概率更高。

Objective To compare and analyze the clinical effect of laparoscopic fallopian tube preservation and salpingectomy in the treatment of tubal pregnancy.Methods A total of 128 cases of tubal pregnancy treated in Binzhou Medical University Hospital from January 2018 to December 2020 were retrospectively selected as the study objects.According to whether tubal retention was performed under laparoscopy,they were divided into observation group(n=64)and control group(n=64).The observation group received tubal retention treatment under laparoscopy.The control group received laparoscopic fallopian tube resection.The treatment success rate,clinical indexes,follow-up pregnancy outcome and human chorionic gonadotropin(β-HCG)level were compared between the two groups.Results There was no significant difference in treatment success rate between the two groups(P>0.05).The operation time and blood loss in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the recovery time of serumβ-HCG to normal and postoperative hospitalization time between the two groups(P>0.05).There was no significant difference inβ-HCG level between the two groups before operation(P>0.05).Theβ-HCG level in the observation group was higher than that in the control group 3 and 7 days after operation,and the difference was statistically significant(P<0.05).The reduction rate ofβ-HCG in the observation group was lower than that in the control group at 3 and 7 days after operation,and the difference was statistically significant(P<0.05).Conclusions In the treatment of tubal pregnancy,laparoscopic salpingotomy and salpingectomy have a high success rate.Salpingotomy is better than salpingectomy in operation time,intraoperative bleeding and postoperativeβ-HCG reduction.However,tubal preservation surgery has a higher rate of normal pregnancy.