两种药物在输卵管间质部微创取胚术中的应用研究

Comparison effect of two drugs in minimally invasive treatment on interstitial tubal embryo

摘要:

目的 观察腹腔镜下应用垂体后叶素或缩宫素的输卵管间质部妊娠手术的临床效果、安全性及优缺点。方法 选择2009年5月~2013年10月在该院诊断输卵管间质部妊娠61例行腹腔镜下切开取胚术。按入院时间分为垂体后叶素组37例，术中于妊娠包块周围多点注射垂体后叶素；缩宫素组29例，术中于妊娠包块周围多点注射缩宫素。比较垂体后叶素组及缩宫素组的手术成功率、手术时间、术中出血量、术后病率、术后肛门排气时间、术后住院时间及术后持续性异位妊娠发生率等情况。结果 垂体后叶素组腹腔镜手术成功率100%高于缩宫素组68%，差异有显著性（P <0.01）；垂体后叶素组出血量、手术时间与缩宫素组差异有显著性（P <0.05）。术后病率及持续性异位妊娠发生率差异无显著性（P﹥0.05）。结论 腹腔镜下的输卵管间质部妊娠切开取胚手术安全有效，损伤小，术中妊娠包块周围注射垂体后叶素可有效减少术中出血，缩短手术时间，效果优于缩宫素。

Abstract:

【Objective】 To explore clinical effect, safety, advantages and disadvantages of interstitial tubal pregnancy treated with laparoscope using hypophysin or oxytocin compared with laparotomy. 【Methods】 61 cases diagnosed with interstitial tubal pregnancy in our hospital were treated with laparoscopic incision in embryo form May, 2009 to October, 2013. 37 patients were in hypophysin group treated with multipoint injection of hypophysin around enclosed mass with laparoscopic. 29 patients were in oxytocin group treated with multipoint injection of oxytocin around enclosed mass with laparoscopic.The differences of operation time, blood loss, postoperative morbidity, time needed for passage of gas by anus, hospital stay, incidence rate of persistent ectopic pregnancy were compared .between the two groups .【Results】 The operation success rate of hypophysin group is 100%, was significantly higher than that in oxytocin group (P ＜0.01). There is significant difference of operation time and blood loss between hypophysin group and oxytocin group (P ＜0.05). There is no difference of postoperative morbidity and incidence rate of persistent ectopic pregnancy between two groups (P ＞0.05). 【Conclusion】 It's a safe, effective and minimally invasive way of opening-taking embryo operation of interstitial tubal pregnancy by laparoscope. Application of hypophysin injection in opening-taking embryo by laparoscopic operation on lump interstitial tubal pregnancies can reduce blood loss, shorten operation time, which is better than oxytocin.