2015年第12期摘要287腹腔镜

腹腔镜输卵管异位妊娠切开取胚术后输卵管通畅情况的探讨

付凤仙叶红苗杰

（医院妇科微创中心，北京）

目的：探讨腹腔镜输卵管异位妊娠切开取胚术后输卵管通畅情况。方法：回顾分析年9月~年9月28例在外院行腹腔镜输卵管异位妊娠切开取胚术后6个月在我院妇科微创中心门诊行子宫输卵管碘水造影的临床资料，评价输卵管通畅情况。结果：患侧输卵管通畅6例（21.4%），阻塞或积水22例（78.6%）；对侧输卵管通畅19例（67.9%），阻塞或积水9例（32.1%）。3例双侧输卵管均分别行切开取胚术，碘水造影显示2例双侧输卵管均阻塞，1例双侧输卵管均积水；1例右侧输卵管异位妊娠切开取胚术后碘水造影显示阻塞，左侧输卵管异位妊娠药物保守治疗后碘水造影显示通畅。28例随访6~15个月：4例宫内妊娠；4例正在监测排卵；7例正在准备辅助生育；3例输卵管碘水造影后1~2个月行腹腔镜下输卵管积水切开整形术；1例内分泌调节监测排卵；1例碘水造影13个月后出现异常子宫出血行宫腔镜检查，宫腔镜镜下诊断子宫内膜炎，诊断性刮宫子宫内膜病理为增殖期子宫内膜，与月经周期相符合；8例未进一步治疗。结论：腹腔镜输卵管异位妊娠切开取胚术并不能完全改善输卵管通畅情况。

子宫输卵管碘水造影；输卵管异位妊娠；输卵管通畅情况

EvaluationofTubalPatencyAfterLaparoscopicSalpingotomyforTubalEctopicPregnancyFuFengxian*,YeHong*,MiaoJie.*GynecologicalMinimallyInvasiveCenter,BeijingObstetricsandGynecologyHospitalAffiliatedtoCapitalMedicalUniversity,Beijing,China

ObjectiveToexplorethetubalpatencyafterlaparoscopicsalpingotomyandembryoremovalfortubalectopicpregnancy.MethodsAretrospectiveanalysiswasmadeon28patientsreceivinglaparoscopicsalpingotomyatotherhospitalsfromSeptembertoSeptember.Withintheir6postoperativemonths,thesepatientsweregivenhysterosalpingographyinthisgynecologicalminimallyinvasivecentertoevaluatethetubalpatency.ResultsTherewere6casesofipsilateraltubalpatency(21.4%)and22casesoftubalobstructionordropsy(78.6%),while19casesofcontralateraltubalpatency(67.9%)and9casesoftubalobstructionordropsy(32.1%).Bilateraltubalembryoremovalwascarriedoutin3cases,withhysterosalpingographyshowingbilateraltubalobstructionin2casesandbilateraltubaldropsyin1case.Onepatienthadipsilateraltubalobstructionaftertubalembryopatencyanddevelopedcontralateraltubalpatencyafterconservativetreatment.Follow-upofthe28casesfor6-15monthsshowed4casesofintrauterinepregnancy,4casesofexaminationofovulation,7casesofpreparationofassistedreproduction,3casesoflaparoscopicsalpingoplasty1-2monthsafterhysterosalpingography,1caseofendocrineregulationmonitoringovulation,1caseofabnormaluterinebleeding13monthslater(hysteroscopicexaminationshowedendometritisanddiagnosticcurettagefoundproliferativephaseendometriumthatconsistentwiththemenstrualcycle),and8caseswithoutfurthertreatment.ConclusionLaparoscopicsalpingotomyfortubalectopicpregnancydoesnotimprovepatient’stubalpatency.

Hysterosalpingography;Tubalectopicpregnancy;Tubalpatency

转载请注明：http://www.jkgjq.com/jbzl/816.html