腹腔镜下不同术式治疗输多口管积水对多卵巢储备功能及妊娠结局的影响

目的探讨腹腔镜下输卵管近端阻断远端造口术和输卵管切除术2种手术方式治疗单侧输卵管积水对患者卵巢储备功能及妊娠结局的影响。方法78例单侧输卵管积水患者根据不同手术方式分为A组40例和B组38例，A组患者采用腹腔镜下输卵管近端阻断远端造口术治疗，B组患者采用腹腔镜下输卵管切除术；比较2组患者手术前后血清促卵泡生成激素（FSH）、雌二醇（E2）水平及妊娠结局。结果B组患者手术时间短于A组（P〈0．05），且术中出血量少于A组（P〈0．05）；但2组患者术后肛门排气时间和住院时间比较差异均无统计学意义（P〉0．05）。2组患者术后第1、3个月经周期时血清FSH、E2水平与术前比较差异均无统计学意义（P〉0．05）；2组患者术前及术后第1、3个月经周期时血清FSH、E2：水平比较差异均无统计学意义（P〉0．05）。2组患者宫内妊娠率、自然宫内妊娠率和辅助生殖技术下妊娠率比较差异均无统计学意义（P〉0．05）。结论腹腔镜下输卵管近端阻断远端造口术和输卯管切除术对单侧输卵管积水患者卵巢储备功能均无显著影响，均可有效改善患者妊娠结局。但输卵管切除术手术时间短，术中出血量少。

Effect of different laparoscopic operation for treating hydrosalpinx on ovarian reserve function and pregnancy outcome

Objective To explore the effect of laparoscopic tubal proximate blocking combined with distal ostomy and salpingeetomy for treating hydrosalpinx on ovarian reserve function and pregnancy outcome. Methods A total of 78 patients with unilateral hydrosalpinx were divided into group A （n = 40） and group B （n = 38 ） according to different operation. The pa- tients in group A were treated with laparoseopie tubal proximate blocking and distal ostomy while the patients in group B were treated with laparoseopic salpingeetomy. The levels of serum follicle-stimulating hormone （ FSH）, estradiolum （ E2 ） and preg- nancy outcome were compared between the two groups before and after treatment. Results The operation time in group B was shorter than that in group A（ P 〈 0. 05 ）, and the intraoperative blood loss in group B was less than that in group A（ P 〈 0. 05 ）, but there was no significant difference in postoperative anal exhaust time and hospitalization time between the two groups（ P 〉 0. 05 ）. There was no significant difference in serum FSH and E2 levels before operation and on the 1 st and 3rd menstrual cycle after operation in the two groups（ P 〉 0.05 ）. There was no significant difference in serum FSH and E2 levels before operation and on the 1 st and 3rd menstrual cycle after operation between the two groups （P 〉 0.05 ）. There was no significant difference in intrauterine pregnancy rate, unartificial intrauterine pregnancy rate and assisted reproductive technology pregnancy rate between the two groups （P 〉 0.05 ）. Conclusions Laparoscopic tubal proximate blocking combined with distal ostomy and salpingecto- my in treatment of patients with unilateral hydrosalpinx has no significant effect on ovarian reserve function, and can effectively improve pregnancy outcome of patients. Salpingectomy has shorter operation time and less blood loss.