Effect of laparoscopic salpingectomy on ovarian reserve function and serum neuropeptide Y and cortisol in patients with ectopic pregnancy
Received date: 2023-08-29
Online published: 2024-04-08
目的 探究腹腔镜输卵管切除术对异位妊娠患者卵巢储备功能及血清神经肽Y（NPY）、皮质醇（Cor）的影响。 方法 选2018年6月至2021年6月于安徽医科大学附属巢湖医院就诊的异位妊娠患者82例，随机分为两组，每组41例，对照组采用腹腔镜输卵管切开取胚缝合术，观察组采用腹腔镜输卵管切除术治疗。比较两组的手术时间、术中出血量、下床活动时间、出院时间、血清NPY及Cor、卵巢窦卵泡（AFC）个数、卵巢动脉血流速度峰值、阻力指数。术后跟踪随访2年，记录成功妊娠率及异位妊娠率。 结果 观察组手术时间短于对照组（P < 0.05）。术后即刻、术后1周，两组血清NPY差值、Cor差值比较，差异无统计学意义（P > 0.05）。术后1个月、术后6个月，观察组患侧卵巢血流速度峰值均低于对照组，阻力指数高于对照组（P < 0.05）；术后6个月，两组患者的卵巢血流速度峰值均升高，阻力指数均降低（P < 0.05）。术后两组AFC及成功妊娠率比较，差异均无统计学意义（P > 0.05）。观察组异位妊娠率低于对照组（P < 0.05）。 结论 与腹腔镜输卵管切开取胚缝合术比较，腹腔镜输卵管切除术治疗异位妊娠患者，同样可保留术后卵巢AFC，且在降低术后再次异位妊娠风险上更具优势。
时荣 , 郑贤芳 , 陶群 , 陈君墨 , 葛小花 . 腹腔镜输卵管切除术对异位妊娠患者卵巢储备功能及血清神经肽Y、皮质醇的影响[J]. 实用医学杂志, 2024 , 40(6) : 801 -806 . DOI: 10.3969/j.issn.1006-5725.2024.06.012
Objective To explore the effect of laparoscopic salpingectomy on ovarian reserve function and serum neuropeptide Y （NPY） and cortisol （Cor） in patients with ectopic pregnancy. Methods 82 patients with ectopic pregnancy who had visited Chaohu Hospital Affiliated to Anhui Medical University from June 2018 to June 2021 were randomly divided into two groups， with 41 in each group. The control group underwent laparoscopic salpingostomy and suturing for embryo retrieval， while the study group underwent laparoscopic salpingectomy. Surgical duration， intraoperative blood loss， time to postsurgical mobilization， length of hospital stay， serum NPY and Cor levels， antral follicle count （AFC）， indexes for peak flow velocity and resistance of ovarian artery were compared between the two groups. Follow-up was conducted for two years after surgery， and the success rate of pregnancy and the ectopic pregnancy rate were recorded. Results The surgical duration in the study group was shorter than that in the control group （P < 0.05）. The differences in serum NPY and Cor values between the two groups immediately after surgery and at postoperative week one were not statistically significant （P > 0.05）. At postoperative months1 and 6， the peak flow velocity of the affected ovary was lower in the study group than in the control group， whereas the resistance index was higher （P < 0.05）. At postoperative month 6， both groups showed an increase in peak flow velocity and a decrease in resistance index （P < 0.05）. There were no statistically significant differences in AFC and the success rate of pregnancy between the two groups postoperatively （P > 0.05）. The ectopic pregnancy rate in the study group was lower than that in the control group （P < 0.05）. Conclusion As compared with laparoscopic salpingostomy， laparoscopic salpingectomy for ectopic pregnancy can also preserve postoperative ovarian antral follicle count （AFC）， and it has greater advantage in reducing the risk of recurrent ectopic pregnancy after surgery.
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