透明质酸对腹腔镜异位妊娠手术患者的术后粘连预防

Postoperative adhesion prevention of hyaluronic acid on laparoscopic operation for ectopic pregnancy

目的探讨透明质酸对于腹腔镜异位妊娠手术患者的术后粘连预防效果。方法选择进行腹腔镜手术治疗的异位妊娠患者80例,随机分为观察组A和对照组B,每组各40例。观察组术后给予透明质酸凝胶涂抹于手术创面及周围腹腔脏器,对照组常规手术。观察并随访患者术后粘连发生情况。结果观察组术后B超检查出现盆腹腔粘连的概率为17.5%,输卵管造影提示手术侧输卵管阻塞概率为3.23%,低于对照组的35.0%和12.1%(P均<0.05)。观察组中既往有盆腔粘连病史的患者术后B超检查出现盆腹腔粘连的概率为29.4%,输卵管造影提示手术侧输卵管阻塞概率为0,低于对照组的57.9%和15.8%(P均<0.05)。结论在腹腔镜下行异位妊娠手术后应用透明质酸可有效降低术后粘连的发生,对已有盆腔粘连患者预防再次粘连也有效果。

Objective To investigate the postoperative adhesion preventive effect of hyaluronic acid on laparoscopic operation for ectopie pregnancy. Methods 80 cases of ectopic pregnancy treated by laparoscopic operation were selected and randomly divided into two groups： observation group A（40 cases） and control group B（40 cases）. Patients in observation group were treated with hyaluronic acid gel coated on the wound and the surrounding abdominal organs, and patients in control group were treated with conventional surgery. The postoperative adhesion was observed and fellow up. Results After the operation, the probability of abdominal adhesion checked out by B-mode ultrasonography in observation group was 17.5%, and fallopian tube obstruction probability showed by fallopian tube radiography was 3.23%, which were lower than those of control group with 35.0% and 12.1%（P 〈 0.05）. Patients in observation group with history of pelvic adhesion： the probability of abdominal adhesion checked out by B-mode ultrasonography after the operation was 29.4%, and fallopian tube obstruction probability showed by fallopian tube radiography was 0, which were lower than those of control group with 57.9% and 15.8%（P 〈 0.05） Conclusion After laparoscopie surgery for eetopic pregnancy, the application of hyaluronic acid can effectively reduce the incidence of postoperative adhesions, and prevent the recurrence of pelvic adhesions.