腹腔镜与开腹输卵管吻合术后妊娠率的比较

目的探讨腹腔镜输卵管吻合术治疗输卵管绝育术后或单纯输卵管堵塞不孕症的妊娠结局。方法2006年1月-2013年8月，48例要求输卵管吻合术治疗的输卵管绝育术后或单纯输卵管峡部堵塞性不孕症患者，按患者就诊顺序依次进入腹腔镜组和开腹组（各24例），2组均为20例绝育术后，4例不孕症。对2组吻合成功率及术后妊娠情况等进行比较。结果所有手术均顺利完成，术中双侧输卵管均通畅。术后2年妊娠率腹腔镜组高于开腹组87．5％（21／24）vs．62．5％（15／24），x2=4．000，P=0．046]。结论腹腔镜输卵管吻合术的手术成功率与开腹手术相当，而术后妊娠率高于开腹组，且手术创伤小，有广阔的应用空间。

Comparison of Fertility Rates Between Laparoscopic and Open Oviduct Anastomosis

Objective To study the clinical characteristics of laparoscopic oviduct anastomosis for the treatment of fallopian tube sterilization or tubal infertility. Methods A total of 48 cases of fallopian tube sterilization or tubal infertility patients underwent oviduct anastomosis between January 2006 and August 2013 in our hospital. The patients were divided equally into laparoscopic surgery group （laparoscopic group, 24 cases） or open surgery group （ open group, 24 cases） in chronological order. The ratio of infertility patient was equal in both laparoscopic surgery group and open surgery group. Repatency rate and pregnancy rate of different surgical procedures were analyzed, respectively. Results All the operations were successfully completed. Bilateral tubal repatency rate was 100% in all the patients during the operation. The pregnancy rate of laparoscopic surgery group （87.5% ,21/24） was higher than that in the open surgery group （62.5% , 15/24） within 24 months after surgery, with significant difference （X2 = 4. 000, P = 0. 046）. Conclusions The success rate of laparoscopic oviduct anastomosis is comparable to open surgery. However, the pregnancy rate after laparoscopic oviduct anastomosis is higher than open surgery. Laparoscopic oviduct anastomosis has a broad prospect of application.