不同手术方法对输卵管妊娠患者卵巢储备功能影响的临床研究

发布时间：2018-05-28 03:12

本文选题：卵巢储备功能 + 输卵管妊娠　；参考：《蚌埠医学院》2017年硕士论文

【摘要】：目的通过对输卵管妊娠患者施行不同的手术治疗,观察不同的手术方法对其卵巢储备功能的影响。方法选择2015年1月至2017年3月于蚌埠医学院第一附属医院就诊,因输卵管妊娠需手术治疗的患者120例,将其分为A、B、C三组,A组行腹腔镜下输卵管切除术,B组行腹腔镜下输卵管切开取胚术,C组行腹腔镜下输卵管部分切除术。同时选取40名健康体检者作为对照组,分别检测3组患者术后1、3个月经周期及健康体检者的血清卵泡刺激素(Follicle stimulating hormone,FSH)、黄体生成素(Luteinizing hormone,LH)、雌二醇(Estradiol,E2)、孕酮(progesterone,P)、睾酮(testosterone,T)水平。并检测3组患者术前,术后1、3个月经周期,健康体检者的抗苗勒氏管激素(Anti Mullerian hormone,AMH)水平。采用经阴道多普勒超声技术,分别检测患者两侧卵巢的窦卵泡数(antral follicle count,AFC)。结果四组患者的年龄,停经时间,血清绒毛膜促性腺激素等一般资料无统计学差异(P0.05)。A组患者术后1、3个月经周期的FSH、LH水平比对照组升高,差异有统计学意义(P0.05)。E2、P、T、AMH水平较对照组降低(P0.05);B、C组与对照组相比,其FSH、LH、E2、P、T、AMH水平均无明显差异(P0.05),且A组术后1个月经周期与术后3个月经周期的数据相比,无明显差异(P0.05)。A组健侧卵巢与手术切除输卵管的患侧卵巢相比,AFC明显减少(P0.05)。结论腹腔镜下输卵管切除术对卵巢储备功能有影响,输卵管切除术后,导致卵巢储备功能下降,腹腔镜下输卵管切开取胚术及腹腔镜下输卵管部分切除术对卵巢储备功能无明显影响。
[Abstract]:Objective to observe the effect of different surgical methods on ovarian reserve function in patients with tubal pregnancy. Methods from January 2015 to March 2017, 120 patients who needed surgical treatment for tubal pregnancy in the first affiliated Hospital of Bengbu Medical College were selected. Group A was divided into three groups: group A underwent laparoscopic salpingotomy and group B underwent laparoscopic oviduct incision and embryo extraction. Group C underwent laparoscopic partial salpingotomy. Serum follicle stimulating hormone (Follicle stimulating hormoneation), luteinizing hormone (LHH), estradiol (Estradiolium), progesterone (progesterone), testosterone (T) were measured in 40 healthy persons as control group after 1, 3 menstrual cycles and 1, 3 menstrual cycles after operation, and the levels of serum follicle stimulating hormone (Follicle stimulating), luteinizing hormone (LHH), estradiol (Estradiol), progesterone (progesterone), testosterone (T) were measured. The levels of anti-Mullerian Mullerian hormone (Anti Mullerian hormoney) were measured before operation, 1 and 3 menstrual cycles after operation in the three groups. Transvaginal Doppler ultrasound was used to detect antral follicle count of antral follicle. Results there was no significant difference in age, menopause time and serum chorionic gonadotropin between the four groups. Compared with the control group, there was no significant difference in the levels of TAMH between the two groups, and the data of one menstrual cycle and three menstrual cycles in group A were significantly lower than those in the control group (P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05, P 0.05 respectively. There was no significant difference in AFC between the normal and the affected oviducts in group P0.05A, and the number of AFC in group A was significantly lower than that in group A (P 0.05). Conclusion Laparoscopic salpingotomy has an effect on ovarian reserve function, and the ovarian reserve function decreases after salpingotomy. Laparoscopic oviduct incision and partial salpingotomy had no significant effect on ovarian reserve function.
【学位授予单位】：蚌埠医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R713.8

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