CAJ | 학술논문

目的：探讨输卵管妊娠患者在施行妊娠病灶清除术时行输卵管管腔内防粘连导丝植入术并行相应类型的输卵管重建术的手术可行性及其手术设计方案。方法对术中每一步骤所需的条件做详细可行性分析并设计出相应的手术细节，对手术难点重点找出可行性解决方法并详述。结果有生育要求输卵管妊娠患者保守手术后，管腔内放置防粘连导丝可有效改善输卵管术前通而不畅及术后粘连加重，术中输卵管窗口缝合术或已破裂病灶段切除后两断端吻合术有改善单纯开窗术后输卵管解剖结构改变、患处管腔粘连、创面与周围组织粘连所致继发性患侧输卵管不通可能。结论输卵管炎症、多次的宫腔、盆腔手术操作以及所诱发的炎性改变等均可致输卵管妊娠发病率明显增加，治疗原发病，降低再次异位妊娠发病率及增加日后正常受孕概率是今后研究的重点。
목적：탐토수란관임신환자재시행임신병조청제술시행수란관관강내방점련도사식입술병행상응류형적수란관중건술적수술가행성급기수술설계방안。방법대술중매일보취소수적조건주상세가행성분석병설계출상응적수술세절，대수술난점중점조출가행성해결방법병상술。결과유생육요구수란관임신환자보수수술후，관강내방치방점련도사가유효개선수란관술전통이불창급술후점련가중，술중수란관창구봉합술혹이파렬병조단절제후량단단문합술유개선단순개창술후수란관해부결구개변、환처관강점련、창면여주위조직점련소치계발성환측수란관불통가능。결론수란관염증、다차적궁강、분강수술조작이급소유발적염성개변등균가치수란관임신발병솔명현증가，치료원발병，강저재차이위임신발병솔급증가일후정상수잉개솔시금후연구적중점。
Objective?To?investigate?feasibility?and?operation?design?when?the?patients?with?tubal?pregnancy?underwent?pregnancy?focus?debridement,?implantated?guide?wire?of?preventing?tubal?adhesion?,?and?corresponding?types?of?tubal?reconstruction?operation.?Method?To?do?a?detailed?feasibility?analysis and design details of operation corresponding to the required for each step of operation conditions ,to ifnd feasible solutions and details for the major dififculties of operation. Results?For?the?the?patients?with?tubal?pregnancy?having?the?fertility?requirements,implantation?guide?wire?of?preventing?adhesion?in?the?tubal?can?effectively?improve?the?preoperative?poor?communication?and?postoperative?adhesion?exacerbation?after?conservative?operation,?fallopian?window?suture?or?segmental?resection?and?anastomosis?of?ruptured?lesions?can?improved?fallopian?tube?obstruction?caused?by?tubal?anatomy?affected,?affected?part?adhesion,?wound?adhesion?with?the?surrounding?tissue?after?only?fenestration.?Conclusion?Tubal inlfammation, repeated uterine cavity, pelvic surgical procedures as well as induced inlfammatory changes, etc. can cause signiifcantly increased incidence of tubal pregnancy, treatment of the primary disease, reduce?the?incidence?of?ectopic?pregnancy?and?increased?again?after?normal?pregnancy?probability?is?future?research?priorities.