摘要
目的:探究不同手术方案治疗输卵管妊娠对患者卵巢储备功能及生活质量的影响。方法:将2021年1月-2023年12月本院收治的186例输卵管妊娠患者随机设为3组行腹腔镜手术,取胚组(n=62)行输卵管切开取胚术,传统组(n=62)行传统输卵管切除术,切除组(n=62)行输卵管抽芯切除术。比较各组围术期指标、血清指标、超声指标、生活质量及术后并发症。结果:3组住院时间、术中出血量无差异(P>0.05);传统组、切除组手术时间(45.26±7.02min、45.73±6.29min)短于取胚组(50.32±8.12min)(均P<0.05)。抗缪勒管激素(AMH)取胚组、切除组术后1个月(2.99±0.36ng/ml、2.98±0.41ng/ml)、6个月(3.81±0.61ng/ml、3.79±0.69ng/ml)高于传统组(1.60±0.31ng/ml、2.83±0.52ng/ml),传统组术后6个月FSH(10.82±2.92U/L)、LH(8.04±2.06U/L)高于取胚组(7.91±2.14U/L、6.26±1.80U/L)和切除组(7.40±2.02U/L、5.97±1.63U/L);窦状卵泡数目取胚组、切除组术后1个月(6.53±1.07个、6.96±1.19个)、6个月(7.86±1.82个、8.02±2.04个)高于传统组(5.16±0.83个、6.62±1.37个)(均P<0.05)。3组术前、术后1个月卵巢体积相比无差异(P>0.05),术后6个月卵巢体积取胚组、切除组(9.57±2.47cm^(3)、10.04±2.96cm^(3))高于传统组(8.42±2.06cm^(3))(均P<0.05)。3组术前、术后1个月生活质量评分无差异(P>0.05);术后6个月生活质量评分取胚组、切除组(88.04±9.63分、87.26±10.40分)高于传统组(76.15±8.02分)(均P<0.05)。并发症总发生率3组无差异(P>0.05)。结论:腹腔镜下输卵管抽芯切除术或切开取胚术对输卵管妊娠患者卵巢储备功能影响小,有助于提升患者术后生活质量。
Objective:To explore the effects of the different surgical procedures for treating patients with tubal pregnancy on their ovarian reserve function and quality of life.Methods:186 patients with tubal pregnancy who admitted in the hospital were randomly divided into group A(62 patients with the treatment of salpingotomy and the embryo extraction),group B(62 patients with the treatment of traditional salpingectomy)and group C(62 patients with the treatment of salpingectomy by core pulling)from January 2021 to December 2023.The perioperative indexes values,the serum indexes levels,the ultrasound indexes values,the quality of life and the postoperative complications rate of the patients were compared among the three groups.Results:There were no significant differences in the hospitalization time and the intraoperative blood loss of the patients among the three groups(P>0.05).The operation time of the patients in group B(45.26±7.02min)or group C(45.73±6.29min)was significantly shorter than that(50.32±8.12min)of the patients in group A(all P<0.05).The anti-mullerian hormone(AMH)levels of the patients in group A and in group C in 1 month after operation(2.99±0.36ng/ml and 2.98±0.41ng/ml)and in 6 months after operation(3.81±0.61ng/ml in 1 month after operation and 3.79±0.69ng/ml)were significantly higher than those(1.60±0.31ng/ml in 1month after operation and 2.83±0.52ng/ml in 6 months after operation)of the patients in group B.The levels of FSH(10.82±2.92U/L)and LH(8.04±2.06U/L)of the patients in group B in 6months after operation were significantly higher than those(7.91±2.14U/L and 6.26±1.80U/L)of the patients in group A and those(7.40±2.02U/L and 5.97±1.63U/L)of the patients in group C.The number of antral follicles of the patients in group A and group C in 1month after operation(6.53±1.07and 6.96±1.19)and in 6months after operation(7.86±1.82and 8.02±2.04)were significantly higher than those(5.16±0.83in 1month after operation and 6.62±1.37in 6months after operation)of the patients in group B(all P<0.05).There was no significant difference in the ovarian volume of the patients before operation or in 1month after operation among the three groups(P>0.05).The ovarian volume of the patients in group A or in group C(9.57±2.47cm^(3) or 10.04±2.96cm^(3))in 6months after operation was significantly higher than that(8.42±2.06cm^(3))of the patients in group B(all P<0.05).There was no significant difference in the quality of life score of the patients among the three groups before and 1month after operation(P>0.05).The quality of life score of the patients in group A or in group C(88.04±9.63points or 87.26±10.40points)in 6months after operation were significantly higher than that(76.15±8.02points)of the patients in group B(all P<0.05).There was no significant difference in the total incidence of the complications of the patients among the three groups(P>0.05).Conclusion:The laparoscopic salpingectomy by core pulling or salpingotomy and the embryo extraction for treating patients with tubal pregnancy has less impact on their ovarian reserve function,and which is helpful to improve the postoperative quality of life of the patients.
作者
王孙英
郎苏萍
王宏达
WANG Sunying;LANG Suping;WANG Hongda(Hangzhou Fuyang District Maternal and Child Health Care Hospital,Hangzhou,Zhejiang Province,310000)
出处
《中国计划生育学杂志》
2025年第2期263-268,共6页
Chinese Journal of Family Planning
关键词
输卵管妊娠
腹腔镜手术
输卵管切除
抽芯切除
卵巢储备功能
生活质量
Tubal pregnancy
Laparosc opicoperation
Salpingectomy
Ectomy by core pulling
Ovarian reserve function
Quality of life
