论文部分内容阅读
目的探讨腹腔镜手术与开腹手术对异位妊娠患者生育功能的影响。方法选取2012年8月—2016年4月于重庆市人口和计划生育科学技术研究院附属医院收治的异位妊娠患者120例。根据手术术式不同将患者分为开腹组与腹腔镜组,各60例。开腹组患者予以开腹手术治疗,腹腔镜患者予以腹腔镜手术治疗。比较两组患者手术情况[术中出血量、手术时间、下床活动时间、术后排气时间、术后24 h视觉模拟评分(VAS)评分,住院时间]、输卵管再通率,术后1个月、6个月卵巢储备功能(黄体生成素、卵泡刺激素、雌二醇、卵泡数),随访1年,观察患者再次妊娠及再次异位妊娠情况。结果腹腔镜组患者术中出血量、术后24 h VAS评分低于开腹组,手术时间、下床活动时间、术后排气时间、住院时间短于开腹组(P<0.05)。腹腔镜组患者术后输卵管再通率为83.3%,高于开腹组的61.7%(P<0.05)。腹腔镜组患者术后1个月、6个月黄体生成素、卵泡刺激素、雌二醇水平低于开腹组,卵泡数多于开腹组(P<0.05)。腹腔镜组患者术后1年再次妊娠率高于开腹组(P<0.05)。两组患者术后1年再次异位妊娠率比较,差异无统计学意义(P>0.05)。结论异位妊娠保留生育功能患者实施腹腔镜手术治疗效果优于开腹手术,其可更有效促进患者输卵管再通及再次妊娠,对患者损伤较小。
Objective To investigate the effects of laparoscopic surgery and laparotomy on the reproductive function of patients with ectopic pregnancy. Methods A total of 120 patients with ectopic pregnancy who were admitted to Chongqing Municipal Population and Family Planning Institute of Science and Technology from August 2012 to April 2016 were selected. The patients were divided into laparotomy group and laparoscopic group according to different surgical procedures, 60 cases in each group. Patients in the open group underwent laparotomy and laparoscopic patients underwent laparoscopic surgery. The operative conditions (intraoperative blood loss, operation time, ambulation time, postoperative exhaust time, visual analogue scale (VAS) score at 24 h postoperatively, hospital stay), tubal recanalization rate, postoperative 1 Months, 6 months, ovarian reserve (luteinizing hormone, follicle stimulating hormone, estradiol, follicular number), followed up for 1 year to observe the patient again pregnancy and ectopic pregnancy again. Results The amount of bleeding during operation in laparoscopic group was lower than that in open group at 24 hours after operation. The operation time, ambulation time, postoperative exhaust time and hospital stay were shorter than those in open group (P <0.05). The postoperative tubal recanalization rate in laparoscopic group was 83.3%, which was higher than that in open group (61.7%, P <0.05). The levels of luteinizing hormone, follicle stimulating hormone and estradiol in laparoscopic group were lower than those in laparotomy group at 1 month and 6 months after laparoscopic surgery. The number of follicles in laparoscopic group was more than that in laparotomy group (P <0.05). The pregnancy rate of laparoscopic group was higher than that of laparotomy group after 1 year (P <0.05). There was no significant difference in ectopic pregnancy rate between the two groups at 1 year after operation (P> 0.05). Conclusions Laparoscopic surgery is superior to laparotomy in patients with ectopic pregnancy who have retained fertility. It is more effective in promoting recanalization of the fallopian tube and pregnancy again, with less damage to the patients.