葡萄糖溶液冲洗剥离面止血在腹腔镜保守治疗输卵管妊娠的价值

Glucose irrigation for dissection surface hemostasia in laparoscopic conservative treatment of tubal pregnancy

目的 探讨 5 %葡萄糖液冲洗输卵管妊娠剥离面止血在腹腔镜保守治疗输卵管妊娠的临床应用价值。 方法比较葡萄糖液冲洗输卵管妊娠剥离面止血 (观察组 )与单极电凝止血 (对照组 )各 4 3例中保留输卵管失败的例数、术后内出血、持续妊娠、患侧输卵管再次妊娠和正常宫内妊娠等临床指标。 结果 保留输卵管失败对照组 (10 / 4 3,2 3% )高于观察组 (0 /4 3) (χ2 =11 316 ,P =0 0 0 1) ;患侧输卵管再次妊娠对照组 (2 / 34,6 % )与观察组 (0 / 34)无差异 (P =0 175 )。两组均无术后腹腔内出血和持续妊娠。正常宫内妊娠率观察组 4 4 1% (15 / 34) ,对照组 4 0 0 % (10 / 2 5 ) ,两组差异无显著性 (χ2 =0 10 0 ,P =0 75 2 )。 结论 用 5 %葡萄糖液冲洗输卵管妊娠剥离面止血方法优于电凝法。

Objective To study the value of 5% glucose irrigation for dissection surface hemostasis in laparoscopic conservative treatment of tubal pregnancy. Methods Clinical parameters including numbers of failure in oviduct sparing, the postoperative intraperitoneal bleeding, persistent pregnancy, recurrent tubal pregnancy on the same side and normal uterine pregnancy were compared between the Experimental Group (glucose irrigation for dissection surface hemostasis; 43 cases) and the Control Group (unipolar electrocogulation hemostasis; 43 cases). Results We failed to reserve the oviduct in 10 patients in the Control Group (10/43, 23%) and in no patients in the Experimental Group (0/43) ( χ 2 =11 316, P =0 001). Recurrent tubal pregnancy on the same side was observed in 2 cases in the Control Group (2/34, 6%) and in no cases in the Experimental Group (0/34), without significant differences ( P =0 175). No postoperative intraperitoneal bleeding or persistent pregnancy was seen in both of the groups. Normal uterine pregnancy rates were 44 1% (15/34) in the Experimental Group and 40.0% (10/25) in the Control Group, without significant differences between the two groups ( χ 2 =0 100, P =0 752). Conclusions Use of 5% glucose irrigation is superior to electrocogulation for dissection surface hemostasis in the treatment of tubal pregnancy.