腹腔镜下输卵管切除术与输卵管开窗取胚术治疗输卵管妊娠后妊娠状态的研究.doc

腹腔镜下输卵管切除术与输卵管开窗取胚术治疗输卵管妊娠后妊娠状态的研究 董延磊 朱琳 （山东大学第二医院妇科，济南 250033） [摘要] 目的：探讨腹腔镜下输卵管切除与输卵管开窗取胚两种手术方式对患者妊娠状态的影响。方法：回顾性分析2012年1月-2012年12月在我院确诊为输卵管妊娠而接受腹腔镜手术、有生育要求并有随诊条件的127例患者，据手术方式不同分组；A组是输卵管切除组，共64例；B组是输卵管开窗取胚组，共63例。比较两组术后妊娠状态。结果：术后2年宫内妊娠率：A组29/64（45.3%），B组31/63（49.2%）比较两组无显著性差异（P0.05）；再次异位妊娠率：A组3/64（4.7%），B组10/63（15.9%）；比较两组有显著性差异（P 0.05）。结论：在输卵管妊娠的手术治疗中，输卵管切除与输卵管开窗取胚相比，宫内妊娠率无明显差异，而再次异位妊娠率明显降低。在输卵管妊娠的手术过程中，若患者对侧输卵管外观无明显异常，在充分征得患者及家属知情同意的情况下，应尽量行患侧输卵管切除术。 [关键词]腹腔镜 输卵管切除术 输卵管开窗取胚术 妊娠状态 中图分类号：R713.8 文献标志码：A Study on reproductive outcome of laparoscopic salpingectomy and salpingotomy of ectopic pregnancy DONG Yan-lei，WANG Ya-fen，ZHU Lin （Department of Gynecology，the Second Hospital of Shandong University,Jinan 250033,China） [Abstract] Objective: To investigate the reproductive outcome of laparoscopic salpingectomy and salpingotomy of ectopic pregnancy Methods: 127 cases of ectopic pregnants patient were involved from Jan,2012 to Dec,2012 . which all wish to keep reproductive ability and fallowed up after laparoscope operations ,They were divided into two groups by different types of operations. Group A (n=64) was salpingectomy group. Group B (n=63) was salpingotomy group. The reproductive outcome after laparoscope were investigated. Results: The rate of intrauterine pregnancy and recurrent ectopic pregnancy after laparoscope within 2 years of two groups were compared.Intrauterine pregnancy rate were 45.3% and 49.2%,respectively.There was no significant differences in both groups (P0.05). the recurrent ectopic pregnancy rate were 4.7% and 15.9%,respectively. There was significant differences ( P0.05). Conclusions: The intrauterine pregnancy rate of salpingectomy patients is similar to salpingotomy patients. But the recurrent ectopic pregnancy rate is lower seriously. So, Under the informed consent of the patients and their families, if patient with normal contralateral tubes,we suggest salpingectomy. Keywords laparoscopy operation; salpingectomy; salpingotomy;