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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。
Objective: To observe the tubal function after laparoscopic conservative surgery in tubal pregnancy and explore the value of tubal retention. Methods: The clinical data of 171 cases of tubal pregnancy underwent laparoscopic conservative surgery were retrospectively analyzed. The correlation between preoperative serum human chorionic gonadotropin (HCG) level, intraoperative blood loss and postoperative tubal function recovery was analyzed. Results: According to preoperative serum β-HCG levels, two groups were divided into two groups: 121 in β-HCG≤2 500 IU / L group and 50 in β-HCG> 2500 IU / L group. There was significant difference between the two groups in the amount of bleeding (P <0.01). One hundred and seventy-one cases of tubal patency (81.89%) were performed postoperatively in one month, of which 113 cases (93.39%) had β-HCG≤2,500 IU / L group and β2-HCG> 2,500 IU / L group 27 cases (54.00%). There were 23 cases of ectopic pregnancy on the surgical side again, 12 cases of β-HCG≤2 500 IU / L group accounted for 9.92% and 11 cases of β-HCG> 2500 IU / L group accounted for 22.00%. There were 82 cases (47.95%) of intrauterine pregnancy after operation, of which 69 cases (57.02%) were in β-HCG≤2 500 IU / L group and 13 cases (26.00%) in β-HCG> 2500 IU / L group, There was statistical significance (P <0.05). Conclusion: Laparoscopic conservative surgery for tubal pregnancy effectively reserves the pregnancy side of the fallopian tube, but tubal tissue destruction is not recommended to retain the affected side of the fallopian tube.