CAJ | 학술논문

目的：探讨阴道四维输卵管超声造影术在评价输卵管妊娠经不同的保留输卵管治疗方式后输卵管通畅性中的应用价值。方法选取本院2012年3月~2014年3月收治的输卵管妊娠患者，按治疗方式分为期待疗法组、药物保守治疗组、介入性治疗组、腹腔镜保守手术治疗组，每组30例。输卵管妊娠治疗结束后3~6个月，所有患者进行阴道四维输卵管超声造影术并记录患侧及对侧输卵管通畅性的情况以及宫内妊娠结果，探讨输卵管妊娠不同的治疗方式对输卵管通畅性的影响，再与宫内妊娠结果对比。结果期待疗法组、药物治疗组与腹腔镜保守手术治疗组患侧输卵管通畅率比较，差异有统计学意义（P<0.05）；期待疗法组、药物治疗组与腹腔镜保守手术治疗组双侧输卵管通畅率比较，差异有统计学意义（P<0.05）；其余各组间比较，差异无统计学意义（P>0.05）。腹腔镜保守手术治疗组的宫内妊娠率明显高于期待疗法组、药物治疗组、介入治疗，但各组间差异无统计学意义（P>0.05）。结论腹腔镜保守手术治疗输卵管妊娠可使输卵管功能恢复最佳。阴道四维输卵管超声造影可简单、无创、高效地评价输卵管妊娠治疗后输卵管功能的恢复情况及治疗效果，进而预测宫内妊娠、再次异位妊娠的发生率，具有很高的经济及社会价值，值得临床推广应用。
목적：탐토음도사유수란관초성조영술재평개수란관임신경불동적보류수란관치료방식후수란관통창성중적응용개치。방법선취본원2012년3월~2014년3월수치적수란관임신환자，안치료방식분위기대요법조、약물보수치료조、개입성치료조、복강경보수수술치료조，매조30례。수란관임신치료결속후3~6개월，소유환자진행음도사유수란관초성조영술병기록환측급대측수란관통창성적정황이급궁내임신결과，탐토수란관임신불동적치료방식대수란관통창성적영향，재여궁내임신결과대비。결과기대요법조、약물치료조여복강경보수수술치료조환측수란관통창솔비교，차이유통계학의의（P<0.05）；기대요법조、약물치료조여복강경보수수술치료조쌍측수란관통창솔비교，차이유통계학의의（P<0.05）；기여각조간비교，차이무통계학의의（P>0.05）。복강경보수수술치료조적궁내임신솔명현고우기대요법조、약물치료조、개입치료，단각조간차이무통계학의의（P>0.05）。결론복강경보수수술치료수란관임신가사수란관공능회복최가。음도사유수란관초성조영가간단、무창、고효지평개수란관임신치료후수란관공능적회복정황급치료효과，진이예측궁내임신、재차이위임신적발생솔，구유흔고적경제급사회개치，치득림상추엄응용。
Objective To explore the application value of tubal patency by different therapeutic methods in fallopian pregnancy evaluated by vaginal four-dimensional ultrasonography of fallopian tube. Methods Patients with fallopian pregnancy treated in our hospital from March 2012 to March 2014 were selected,and were divided into expectant treat-ment group,conservative drug therapy group,interventional treatment group,and laparoscopic conservative surgery group according to different treatment methods,each group with 30 cases.Patients were examined by vaginal four-dimensional ultrasonography of fallopian tube 3-6 months after finishing tubal pregnancy treatment.The tubal patency in affected and opposite sides were both recorded,the influence on tubal patency by different therapeutic methods in fallopian pregnancy was explored,which was compared with that in uterine pregnancy. Results There was statistical difference in patency rate of affected side and bilateral sides of fallopian tube between conservative drug therapy group and laparo-scopic conservative surgery group,and between expectant treatment group and laparoscopic conservative surgery group (P<0.05).Intrauterine pregnancy rate of laparoscopic conservative surgery group was higher than that of the other three groups,but the difference was not significant (P>0.05). Conclusion Functional recovery of fallopian tube is best in la-paroscopic conservative surgery group.Vaginal four-dimensional ultrasonography of fallopian tube can simply,non-inva-sively,and effectively evaluate functional recovery of fallopian tube after treatment of tubal pregnancy,and then predict the incidence of uterine pregnancy,which is worthy of application and promotion in clinic.