摘要
目的 探讨保留输卵管系膜的输卵管切除术对卵巢储备功能的影响.方法 收集2020年1月—2021年3月收治的输卵管疾病患者281例为研究对象,按照治疗方式的不同分为传统双侧切除组(n=53,行传统双侧输卵管切除术)、传统单侧切除组(n=56,行传统单侧输卵管切除术)、保留双侧切除组(n=60,行保留输卵管系膜的双侧输卵管切除术)、保留单侧切除组(n=54,行保留输卵管系膜的单侧输卵管切除术)、对照组[n=58,无输卵管切除术史的体外受精-胚胎移植(IVF-ET)患者].比较各组患者手术时间、术中出血量和术后排气时间.患者术后2个月行IVF-ET并检测卵泡数量、卵子数量、妊娠率和受精率.IVF-ET后检测患者外周血抗苗勒氏管激素(AMH)、促卵泡生成素(FSH)、雌二醇(E2)、黄体生成素(LH)水平.随访至2023年3月,记录5组患者妊娠成功率.结果 传统双侧切除组、传统单侧切除组、保留双侧切除组、保留单侧切除组患者围术期手术时间、术中出血量和术后排气时间比较,差异无统计学意义(P＞0.05).行IVF-ET后,5组患者AMH、FSH、E2和LH水平比较,差异有统计学意义(P＜0.05),AMH和E2水平由低到高为传统双侧切除组、传统单侧切除组、保留双侧切除组、保留单侧切除组、对照组,FSH和LH水平由高到低为传统双侧切除组、传统单侧切除组、保留双侧切除组、保留单侧切除组、对照组.随访至2023年3月,传统双侧切除组、传统单侧切除组、保留双侧切除组、保留单侧切除组和对照组妊娠成功率分别为45.28％、50.00％、53.33％、59.26％、58.62％,5组患者行IVF-ET后妊娠成功率比较,差异无统计学意义(x2=3.044,P=0.551).结论 与传统的输卵管切除术比较,保留输卵管系膜的输卵管切除术对卵巢储备功能影响较小.
Abstract
Objective To investigate the impact of salpingectomy with preservation of fallopian tube mesentery on ovarian reserve function.Methods A total of 281 patients with tubal disease who were admitted from January 2020 to March 2021 were collected as research objects.According to the different treatment methods,they were divided into traditional bilateral resection group(n=53,con-ventional bilateral salpingectomy),traditional unilateral resection group(n=56,conventional unilat-eral salpingectomy),preservation of bilateral resection group(n=60,bilateral salpingectomy with preservation of fallopian tube mesentery),preservation of unilateral resection group(n=54,unilater-al salpingectomy with preservation of fallopian tube mesentery),and control group[n=58,patients with in vitro fertilization-embryo transfer(IVF-ET)but no history of salpingectomy].The operation time,intraoperative blood loss,and postoperative exhaust time were compared among the groups.Two months after the operation,IVF-ET was performed,and the number of follicles and oocytes,pregnan-cy rate,and fertilization rate were detected.The levels of anti-mullerian hormone(AMH),follicle-stimulating hormone(FSH),estradiol(E2),and luteinizing hormone(LH)in peripheral blood were detected after IVF-ET.Follow-up was conducted until March 2023,and pregnancy success rates were recorded for the five groups.Results There were no significant differences in perioperative opera-tion time,intraoperative blood loss,and postoperative exhaust time among traditional bilateral resec-tion group,traditional unilateral resection group,preservation of bilateral resection group,preserva-tion of unilateral resection group(P＞0.05).After IVF-ET,there were significant differences in AMH,FSH,E2,and LH levels among the five groups(P＜0.05).The levels of AMH and E2 in a rising sequence were traditional bilateral resection group,traditional unilateral resection group,pres-ervation of bilateral resection group,preservation of unilateral resection group and control group,while the levels of FSH and LH in descending sequencing were traditional bilateral resection group,traditional unilateral resection group,preservation of bilateral resection group,preservation of unilat-eral resection group and control group.Follow-up was conducted until March 2023,and the preg-nancy success rates after IVF-ET were 45.28％,50.00％,53.33％,59.26％,and 58.62％in the traditional bilateral resection group,traditional unilateral resection group,preservation of bilater-al resection group,preservation of unilateral resection group,and control group,respectively.There was no significant difference in pregnancy success rate after IVF-ET among the five groups(x2=3.044,P=0.551).Conclusion Compared with traditional salpingectomy,salpingectomy with preservation of fallopian tube mesentery has less impact on ovarian reserve function.
基金项目
海南省自然科学基金(20A200035琼卫教科20209号)
海南省临床医学中心建设项目(琼卫医涵202175号)
维普
万方数据