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目的:分析并探讨腹腔镜输卵管切除术对输卵管妊娠患者生殖潜能的影响。方法:选取本院收治的输卵管妊娠患者480例,研究组336例,采用腹腔镜输卵管切除术进行治疗;144例为对照组,采用腹腔镜保留患侧输卵管的保守手术,测定治疗后两组患者的性激素水平、超声测量卵巢体积、窦卵泡数量、排卵率及生育结局,比较两组患者生育状况。结果:同对照组相比,研究组的卵泡刺激素(FSH)、黄体生成素(LH)显著升高(P<0.05);雌二醇(E2)、血清抗苗勒管激素(AMH)水平术后1个月、3个月显著降低(P<0.05),术后6个月稍有降低(P>0.05);卵巢体积及窦卵泡数显著降低(P<0.05);术后半年排卵率和术后妊娠率稍有降低,但差异无统计学意义(P>0.05);术后异位妊娠率,研究组显著低于对照组(P<0.05),尤其是术中保留的患侧输卵管发生再次异位妊娠的可能性更大。结论:输卵管切除术影响患者生殖潜能,但可降低再次异位妊娠的发生率。输卵管妊娠的患者是否行输卵管切除术,取决于输卵管的病变情况及患者的生育要求。
Objective: To analyze and discuss the influence of laparoscopic tubal resection on the reproductive potential of patients with tubal pregnancy. Methods: Forty-eight patients with tubal pregnancy admitted to our hospital and 336 patients in study group were selected for laparoscopic salpingo-oophorectomy. One hundred and forty-four patients served as control group. Laparoscopic conservative operation of tubal obstruction was performed. Of sex hormones, ultrasound measurement of ovarian volume, the number of antral follicles, ovulation rate and fertility outcomes, fertility status of the two groups were compared. Results: Compared with the control group, the FSH and LH of the study group were significantly increased (P <0.05); the levels of estradiol (E2), serum anti-Mullerian hormone (AMH) The ovarian volume and the number of antral follicles decreased significantly at 1 month and 3 months postoperatively (P <0.05), and 6 months postoperatively (P0.05) (P <0.05). The rate of postoperative ectopic pregnancy was significantly lower in the study group than in the control group (P <0.05), especially in the patients with tubal ipsilateral tubal Occur again more likely ectopic pregnancy. Conclusion: The tubal resection affects the reproductive potential of patients, but can reduce the incidence of ectopic pregnancy again. Tubal pregnancy patients undergoing tubal resection, depending on the tubal lesions and the patient’s reproductive requirements.