联合应用垂体后叶素与肾上腺素对腹腔镜下输卵管妊娠开窗取胚术的价值

Clinical value of combined application of pituitrin and epinephrine in laparoscopic salpingotomy for tubal pregnancy

摘要:

目的 探讨不同预处理方法运用于腹腔镜下输卵管妊娠开窗取胚术的安全性及可行性。方法 回顾性病例对照分析2014年10月－2018年10月120例在该院行腹腔镜下输卵管妊娠开窗取胚术的未破裂输卵管妊娠患者的临床资料，根据是否联合应用肾上腺素，将患者分为对照组（n = 58）和观察组（n = 62例）。对照组在子宫角部偏后方与卵巢固有韧带间的宫壁浅肌层单纯注射垂体后叶素6 u，观察组行上述处理的同时，于病变输卵管系膜内注射5 mL稀释的肾上腺素盐水（1∶1 200）。观察两组患者手术时间、术中出血量、β-人绒毛膜促性腺激素（β-HCG）转阴时间和持续性异位妊娠发生率。结果 观察组手术时间、术中出血量、β-HCG转阴时间均少于对照组（P < 0.05）。结论 联合应用垂体后叶素与肾上腺素，能有效减少术中出血量，缩短手术时间及β-HCG转阴时间，是一种安全可行的预处理方法。

Abstract:

Objective To investigate the safety and feasibility of different pretreatment methods in laparoscopic salpingotomy for tubal pregnancy.Methods Retrospective case-control analysis was conducted to analyze the clinical data of 120 patients with unruptured tubal pregnancy who underwent laparoscopic fenedotomy for tubal pregnancy from October 2014 to October 2018. According to the combination of epinephrine, the patients who met the requirements were divided into two groups. The control group (n = 58): 6 u hypophysin injection was injected between the horn of uterus posteriorly and ovarian proper ligament, Observation group (n = 62): At the same time of the above treatment, 5 mL diluted epinephrine saline (1∶1 200) was injected into the mesosalpinx of the lesion. After two treatments, the operative time, intraoperative blood loss, β-human chorionic gonadotropin（β-HCG） negative time, and the incidence of persistent ectopic pregnancy were observed in both groups.Results The operative time, intraoperative blood loss and negative conversion time of β-HCG in observation group were all lower than those in control group (P < 0.05).Conclusion Combined application of pituitrin and epinephrine can effectively reduce intraoperative blood loss, shorten the operative time and the negative turning time of β-HCG, which is a safe and feasible method.