输卵管妊娠腹腔镜保守性手术后输卵管的功能状况

目的:观察输卵管妊娠腹腔镜保守性手术后输卵管功能状况并探讨输卵管保留的价值。方法:对171例输卵管妊娠行腹腔镜保守性手术治疗患者的临床资料进行回顾分析,比较术前血人绒毛膜促性腺激素(HCG)水平与术中出血量及术后输卵管功能恢复的关系。结果:根据术前血清β-HCG水平分为两组:β-HCG≤2 500 IU/L组121例,β-HCG>2 500 IU/L组50例。两组术中出血量差异有统计学意义(P<0.01)。术后1月行输卵管碘油造影检查,140例手术侧输卵管通畅(81.89%),其中β-HCG≤2 500 IU/L组113例(93.39%),β-HCG>2 500 IU/L组27例(54.00%)。手术侧再次异位妊娠23例,β-HCG≤2 500 IU/L组12例占9.92%,β-HCG>2 500 IU/L组11例占22.00%。术后宫内妊娠82例(47.95%),其中β-HCG≤2 500 IU/L组69例(57.02%),β-HCG>2 500 IU/L组13例(26.00%),两组差异有统计学意义(P<0.05)。结论:输卵管妊娠腹腔镜保守性手术有效地保留了妊娠侧输卵管,但输卵管组织破坏严重者不建议保留患侧输卵管。

Function of fallopian tube after conservative operation of laparoscopy in cases with tubal pregnancy

Objective:To observe the function of fallopian tube after conservative operation of laparoscopy in cases with tubal pregnancy,explore the value of reservation of fallopian tube.Methods:The clinical data of 171 cases with tubal pregnancy receiving conservative operation of laparoscopy were analyzed retrospectively,the level of human chorionic gonadotropin(HCG) in blood before operation and the amount of blood loss during operation were compared,and their relationship with recovery of the function of fallopian tube was analyzed.Results:The cases were divided into two groups according to serum β-HCG level before operation: β-HCG≤2 500 IU/L group(121 cases) and β-HCG>2 500 IU/L group(50 cases);there was significant difference in the amount of blood loss during operation between the two groups(P<0.01);oviduct lipiodol radiography was performed at one month after operation,the fallopian tubes at operation side of 140 cases were unobstructed,including 113 cases in β-HCG≤2 500 IU/L group(93.39%) and 27 cases in β-HCG>2 500 IU/L group(54.00%);23 cases got ectopic pregnancy at operation side,including 12 cases in β-HCG≤2 500 IU/L group(9.92%) and 11 cases in β-HCG>2 500 IU/L group(22.00%);82 cases got intrauterine pregnancy after operation,including 69 cases in β-HCG≤2 500 IU/L group(57.02%) and 13 cases in β-HCG>2 500 IU/L group(26.00%),there was significant difference between the two groups.Conclusion:Conservative operation of laparoscopy on tubal pregnancy can reserve fallopian tube effectively,but for the cases with badly damaged fallopian tubes,it is better not to reserve the fallopian tubes.