垂体后叶素在腹腔镜下治疗输卵管妊娠的应用

Use of hypophysin in laparoscopic treatment of tubal pregnancy

目的 探讨垂体后叶素用于腹腔镜下输卵管妊娠手术中的临床疗效.方法 选择广州市番禺区何贤纪念医院2007年9月～2009年9月的异位妊娠住院患者461例行腹腔镜下输卵管线形切开取胚术,其中观察组245例注射垂体后叶素,对照组216例未注射垂体后叶素,观察两组患者术中出血量、手术时间、止血时间、血压变化等临床情况,并加以统计分析.结果 观察组的术中出血量、手术时间、止血时间均明显小于对照组（t分别为13.97、7.63、38.28,均P〈0.05）;观察组的血压变化不明显;观察组改行输卵管切除率小于对照组（χ^26.59,P〈0.05）;观察组与对照组比较,术后人绒毛膜促性腺激素下降程度、持续性异位妊娠发生率无明显差异;观察组的输卵管通畅率高于对照组（χ^222.18,P〈0.05）.结论 在输卵管妊娠保守性手术中应用垂体后叶素明显减少术中出血量,缩短手术时间,止血效果好,未见明显手术并发症,未增加持续性异位妊娠的发生,但输卵管的通畅率有所增加.

Objective To observe clinical therapeutic effect of hypophysin used in laparoscopic surgery for tubal pregnancy. Methods 461 pregnant women with tubal pregnancy admitted to Panyu District Memorial Hospital in a period from Sep. , 2007 to Sep. , 2009 underwent laparoseopic salpingotomy, of which, 245 patients in the observation group were injected hypophysin in mesosalpinx before salpingotomy, while 216 patients in the control group were not injected any hypophysin. The intraoperative blood loss, operation time, intraoperative hemostasis time, blood pressure changes in the two groups were observed. Results In the observation group, the operation time, intraoperative blood loss and intraoperative hemostasis time were all significantly lower than those in the control group （ t = 13.97, 7.63, 38.28 respectively, all P 〈 0.05 ）. The changes in blood pressure of the patients in the observation group wash＇ t significant. The rate of salpingotomy converting to salpingectomy in the observation group was lower than that in the control group （x^2 = 6.59, P 〈 0.05）. But in postoperative hCG descending speed and incidence rate of postoperative continuous ectopic pregnancy, there were no significant differences between the two groups. But the potency rate of Folloping tube in the observation group was higher than that in the control group. Conclusion Application of hypophysin in conservative surgery of tubal pregnancy can significantly reduce intraoperative blood loss, shorten operation time, and shows a good hemostasis effect, and has no servere operative complications, doesn＇ t increase incidence of continuous ectopic pregnancy, only increases patency rate of the fallopian tube.