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目的分析输卵管妊娠患者的输卵管超微结构改变,探讨输卵管妊娠与妊娠输卵管功能异常的关系。方法选取输卵管妊娠患者行手术切除术,腹腔镜诊断及术后病理诊断为输卵管壶腹部妊娠的患者17例(观察组);并与生育年龄行一侧切除术、病理证实输卵管结构正常的患者7例(对照组)进行比较,采用扫描电镜和透射电镜观察妊娠输卵管黏膜超微结构改变,分析妊娠输卵管壶腹部扫描电镜下相关指标的差异。结果输卵管妊娠患者的妊娠部位输卵管黏膜超微结构改变,妊娠输卵管的纤毛上皮细胞比例显著减少,而分泌细胞比例相对增加,固有层水肿明显;妊娠输卵管纤毛细胞数目[(254.64±6.32)vs(320.88±7.11)]及分泌细胞数目[(590.10±4.88)vs(330.51±4.83)]分别与对照组比较差异有统计学意义(P均<0.01),而纤毛长度与直径两组比较无统计学差异(P均>0.05)。结论妊娠输卵管存在严重超微结构异常改变,导致输卵管功能的改变,为临床治疗输卵管妊娠患者选择保留或进行手术切除患侧输卵管提供参考。
Objective To analyze the changes of tubal ultrastructure in patients with tubal pregnancy and to explore the relationship between tubal pregnancy and tubal dysfunction in pregnancy. Methods 17 cases of tubal ampulla pregnancy diagnosed by surgical resection, laparoscopic diagnosis and postoperative pathological diagnosis were included in this study. One side resection was performed with gestational age, and pathology confirmed that tubal structure was normal Cases (control group) were compared. Scanning electron microscopy and transmission electron microscopy were used to observe the ultrastructural changes of tubal mucosa in pregnancy. The differences of related indicators under the scanning electron microscope were analyzed. Results The ultrastructural changes of tubal mucosa in the pregnant area of patients with tubal pregnancy were significantly decreased, while the proportion of ciliated epithelial cells in the fallopian tubes was significantly decreased, but the proportion of secreting cells was relatively increased. The number of tubal cilia in pregnancy was significantly higher than that in the control group [(254.64 ± 6.32) vs (320.88 ± 7.11) and the number of secretory cells [(590.10 ± 4.88) vs (330.51 ± 4.83) vs control group, respectively), but there was no significant difference between the two groups (P> 0.05). Conclusion There are serious changes in the ultrastructure of tubal pregnancy, resulting in changes in tubal function for the treatment of tubal pregnancy patients choose to retain or surgical removal of the affected side of the fallopian tubes provide a reference.