【摘要】 目的:探究输卵管性不孕患者腹腔镜下盆腔重度粘连分解与妊娠结局的关系。方法:选取2014年1月-2019年6月在本院行腹腔镜手术的盆腔重度粘连输卵管不孕患者118例,根据患者术后盆腔粘连分离方式分组各59例。部分分解组仅分解卵巢及输卵管周围粘连,充分分解组充分松解粘连,尽量恢复子宫、输卵管及卵巢的解剖结构,观察术中、术后情况及妊娠。结果:部分分解组术中出血量、手术时间、住院时间少于充分分解组,妊娠率(39.0%)低于充分分解组(45.8%),足月活产率(21.7%)低于充分分解组(59.3%)(P<0.05)。部分分解组中活产者输卵管功能评分为1分比例较高,充分分解组活产中输卵管功能评分为2分比例较高(P<0.05)。结论:盆腔重度粘连输卵管性不孕患者行腹腔镜手术时粘连分解程度与患者妊娠结局可能有关,提示临床对此类患者行腹腔镜盆腔粘连松解术时,应该权衡盆腔粘连分解程度而施行。更多还原

【Abstract】 Objective: To study the relationship between the laparoscopic separating severe pelvic adhesions of patients with tubal infertility and their pregnancy outcomes. Methods: A total of 118 patients with severe pelvic adhesions and tubal infertility who underwent laparoscopic surgery were selected as the research objects from January 2014 to June 2019. According to the separation method of pelvic adhesions during laparoscopic surgery, these patients were divided into control group and observation group(59 cases in each group). The patients in the control group were given separating loosened adhesions only around the ovaries and fallopian tubes, and the patients in the observation group were given fully separating adhesions and tried to restore the anatomical structure of the uteru, fallopian tube and ovary. The intraoperative and postoperative conditions and the postoperative pregnancy rate of the patients were observed. Results: The intraoperative blood loss, the operation time, and the hospital stay of the patients in the control group were significantly less than those of the patients in the observation group, and the pregnancy rate(39.0%) and full-term live birth rate(21.7%) of the patients in the control group were significantly lower than those(45.8% and 59.3%) of the patients in the group(P<0.05). The proportion of fallopian tube function score of 1 point of the patients with live births in the control group was significantly higher, and the proportion of fallopian tube function score of 2 points of the patients with live births in the observation group was significantly higher(P<0.05). Conclusion: The situation of laparoscopic separating severe pelvic adhesions of patients with tubal infertility is closely related to their pregnancy outcomes, which means when laparoscopic separating severe pelvic adhesions of patients with tubal infertility, the scope of separating adhesion should be weighed based on the pelvic adhesion situation of the patients.更多还原