垂体后叶素在腹腔镜输卵管妊娠挤压取胚术中的应用研究

目的:探讨垂体后叶素在腹腔镜下输卵管妊娠挤压取胚术中的临床效果。方法:将2010年1月～2011年12月在钦州市妇幼保健院确诊为未破裂型输卵管妊娠(除输卵管间质部妊娠外)、有生育要求、具备保留输卵管条件的150例患者分为观察组和对照组1、2。观察组(50例)先行输卵管挤压妊娠物清除术,再将垂体后叶素6 U注射于妊娠部位输卵管浆肌层;对照组1(50例)只行输卵管挤压妊娠物清除术;对照组2(50例)在输卵管妊娠部位注射垂体后叶素后再行切开取胚术。比较3组输卵管保留成功率、手术出血量、手术时间、术后最高体温、持续性异位妊娠发生率等。结果:观察组手术时间、术中出血量明显少于对照组1(P<0.01),与对照组2比较差异无统计学意义(P>0.05);观察组术后输卵管保留成功率明显高于对照组1(P<0.01),患侧输卵管通畅率明显高于对照组1、2(P<0.01);3组术后最高体温及持续性异位妊娠发生率比较差异无统计学意义(P>0.05)。结论:腹腔镜下输卵管挤压妊娠物清除术后再将垂体后叶素6 U注射于妊娠部位输卵管浆肌层能有效减少术中出血量,缩短手术时间,提高输卵管保留成功率及术后输卵管通畅率,手术安全、可靠,副作用少,值得推广。

Study on application of hypophysin in laparoscopic tubal pregnancy embryo extrusion

Objective: To explore the clinical effect of hypophysin in laparoscopic tubal pregnancy embryo extrusion.Methods: One hundred and fifty patients who were diagnosed as unruptured tubal pregnancy(except for tubal interstitial pregnancy) and had birth requirement and condition of reserving fallopian tube in the hospital from January 2010 to December 2011 were divided into observation group,control one group and control two group.The patients in observation group(50 patients) were treated with laparoscopic tubal pregnancy embryo extrusion before injection of hypophysin(6 U) into fallopian tube seromuscular layer of pregnant location;the patients in control one group were treated with laparoscopic tubal pregnancy embryo extrusion;the patients in control two group were treated with laparoscopic tubal pregnancy embryo extrusion after injection of hypophysin(6 U) into fallopian tube seromuscular layer of pregnant location.The successful rates of fallopian tube reservation,the amounts of intraoperative bleeding,operation times,the highest temperatures after operation and the incidence rates of persist ectopic pregnancy in the three groups were compared.Results: The operation time and the amount of intraoperative bleeding in observation group were statistically significantly lower than those in control one group(P < 0.01),compared with those in control two group,there was no statistically significant difference(P > 0.05);the successful rate of fallopian tube reservation after operation in observation group was statistically significantly higher than that in control one group(P < 0.01),the patency rate of fallopian tube of affected side in observation group was statistically significantly higher than those in control one group and control two group(P < 0.01);there was no statistically significant difference in the highest temperature and the incidence rate of persist ectopic pregnancy after operation among the three groups(P > 0.05).Conclusion: Laparoscopic tubal pregnancy embryo extrusion before injection of hypophysin(6 U) into fallopian tube seromuscular layer of pregnant location can effectively reduce the amount of intraoperative bleeding,shorten operation time,improve the successful rate of fallopian tube reservation and patency rate of fallopian tube of affected side after operation;the method is safe and reliable,the adverse reactions are few,thus,the method is worthy to be popularized.