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目的:比较腹腔镜下不同手术方式对输卵管妊娠患者卵巢储备功能的影响效果,探讨最佳治疗措施。方法:选择102例输卵管妊娠患者,随机分为腹腔镜输卵管开窗妊娠物取出术组(A组)、输卵管部分切除术组(B组)、腹腔镜输卵管切除术组(C组),每组各34例。术后1个月后和6个月后观察各组患者的性激素水平,测定卵巢功能,以及随访6个月对其月经异常、围绝经期综合征发生率、术后排卵以及术后妊娠率进行记录与比较。结果:与C组比较,术后1个月、6个月的A组与B组的FSH、LH水平、PSV、EDV以及卵巢横截面积降低明显,E2、P、T水平以及RI则升高明显(P<0.05);与C组比较,术后随访6个月后A组与B组的排卵、妊娠率均增加明显(P<0.05);A组与B组比较,各指标均无统计学差异(P>0.05)。结论:腹腔镜输卵管切除术对患者远期的卵巢储备功能存在影响,在患者自身情况允许的前提下,应行保守性手术治疗措施,从而最大可能的保护输卵管的储备功能。
Objective: To compare the effects of different laparoscopic operative methods on ovarian reserve in patients with tubal pregnancy and to explore the best treatment. Methods: A total of 102 patients with tubal pregnancy were selected and randomly divided into two groups: group A (laparoscopic salpingography), group B (salpingectomy), group C (salpingostomy), group C 34 cases in each. The levels of sex hormones in each group were observed after 1 month and 6 months after surgery. The ovarian function was measured and the abnormal menstruation, the incidence of climacteric syndrome, the postoperative ovulation and the pregnancy rate were measured 6 months after follow-up Record and compare. Results: Compared with group C, the levels of FSH, LH, PSV, EDV and ovarian cross-sectional area decreased significantly in groups A and B at 1 month and 6 months after operation, while the levels of E2, P, T and RI increased (P <0.05). Compared with group C, the ovulation and pregnancy rates of group A and group B increased significantly after 6 months of follow-up (P <0.05). There was no statistical difference between group A and group B Learning difference (P> 0.05). Conclusion: Laparoscopic tubal resection has a long-term effect on ovarian reserve in patients. Under the premise of patients’ own circumstances, conservative surgical treatment should be taken to protect the function of tubal reserve as much as possible.