垂体后叶素在腹腔镜输卵管妊娠保守性手术中的应用(1)
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【摘要】 目的 探讨局部注射垂体后叶素在腹腔镜下输卵管妊娠开窗取胚术中的安全性和可行性。方法 采用单中心、前瞻性、随机对照的研究方法,选取2006年3月至2009年12月我院妇科未破裂输卵管妊娠患者126例,均行腹腔镜下输卵管开窗取胚术,其中术中使用垂体后叶素组(观察组)65例,未使用垂体后叶素组(对照组)61例,比较两组的手术时间、术中出血量、术后病率、手术并发症、持续性宫外孕的发生率,术后输卵管通畅度等。结果 观察组的手术时间、术中出血量和持续性宫外孕等并发症发生率均明显少于对照组,术后输卵管通畅度明显高于对照组。结论 腹腔镜下输卵管妊娠开窗取胚术中应用垂体后叶素,能减少术中出血,缩短手术时间,且能显著提高术后输卵管通畅度,是一种安全可靠且值得推广的方法。
【关键词】
腹腔镜; 异位妊娠; 垂体后叶素; 输卵管开窗取胚术
The experiment of pituitr used inlaparoscopic salpingotomyfor Ectopic Pregnancy
XU Lei.Department of gynaecology and obstetrics, Maternal and Child Health Hospital of ZiBo ShanDong ShanDong 255000,China
【Abstract】 Objective To evaluate the safety and the feasibility of hypophysin injection for hemostasis during laparoscopic salpingotomy for tube pregnancy.Methods 126 cases of unruptured tube pregnancy treated by laparoscopic salpingotomy from March 2006 to December 2009 were retrospectively analyzed.65 patients had prophylactic dilute hypophysin injection(study group),and 61 patients did not use vasopressin(control group).The operative time,intraoperative blood loss,rate of persistent ectopic pregnancy and postoperative highest temperature of both groups,smooth rate of diseased tube were compared.Results The operative time was significantly shorter,the interoperation bleeding was significantly less,the rate of persistent ectopic pregnancy was significantly less and the smooth rate of diseased tube was significantly short in the study group than in the control group(P<0.05).Conclusion Injection of hypophysin in laparoscopic salpingotomy for tube pregnancy reduces operating time,interoperative bleeding and the rate of persistent ectopic pregnancy,increased the smooth rate of diseased tube.It is a safe and feasible measure during laparoscopic salpingotomy for tube pregnancy.
【Key words】
Laparoscopy; Ectopic pregnancy; Hypophysin; Salpingotomy
异位妊娠是一种常见的妇科疾患,约占总妊娠率的4.5%~16.8%[1]。由于异位妊娠患者越来越趋向年轻化,许多患者迫切需要保留生育功能。这使腹腔镜下输卵管保留术逐渐替代输卵管切除术,成为输卵管妊娠的主要手术方式[2]。我院自2006年3月至2009年12月,对126例未破裂的输卵管妊娠患者行腹腔镜下诊断及输卵管开窗取胚术,术中在输卵管系膜及妊娠包块基底部注射垂体后叶素,取得满意的效果 ......
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