廖敏　许丽湖

【摘要】 目的：探討患侧宫角注射垂体后叶素在输卵管妊娠腹腔镜保守手术治疗中的应用价值。方法：选择未破裂输卵管妊娠确诊患者96例，采用腹腔镜输卵管妊娠保守性手术并随机分组，术中病变输卵管切开前患侧宫角注射垂体后叶素为观察组（50例），未使用垂体后叶素为对照组（46例）；观察两组患者术中出血量、手术时间、输卵管保留成功率、术后发生持续异位妊娠的概率、术后输卵管通畅率情况，并加以统计分析。结果：两组均顺利完成手术，无中转开腹，无术中、术后并发症；观察组与对照组相比术中出血量显著少、手术时间显著短，差异有统计学意义（P<0.01）；术后输卵管保留成功率、输卵管通畅率显著高于对照组，比较差异有统计学意义（P<0.01）。观察组与对照组术后血β-hCG恢复正常时间、持续性异位妊娠发生率，比较差异均无统计学意义（P>0.05）。结论：在输卵管妊娠腹腔镜保守手术中患侧宫角注射垂体后叶素能减少术中出血量、缩短手术时间、提高输卵管保留成功率及术后输卵管通畅率，手术安全可靠，值得推广。

【关键词】 宫角注射； 垂体后叶素； 输卵管妊娠； 腹腔镜保守手术

中图分类号 R713.8 文献标识码 A 文章编号 1674-6805（2016）5-0003-03

【Abstract】 Objective：To study the application value of side palace angle injection of pituitrin in the treatment of laparoscopic conservative surgery for tubal pregnancy.Method：96 patients with confirmed unruptured tubal pregnancy to adopt laparoscopic tubal pregnancy conservative surgery for treatment were selected and they were randomly divided into two groups，among the patients who had palace angle injection with the Pituitrin before the incision of lesion fallopian tube was the observation group（include 50 cases），who hadnt palace angle injection with the Pituitrin was the control group（include 46 cases）.The intraoperative blood loss，operative time，success rate of tubal retention，the probability of persistent ectopic pregnancy occurred after operation，postoperative tubal patency rate in the two groups were observed，and were analyzed by statistics.Result：Two groups were successfully completed surgery，no conversion to laparotomy，no intraoperative and postoperative complications.Bleeding amount of the observation group was significantly reduced compared with the control group，operation time was significantly shortened as well，the differences of the comparison were statistically significant（P<0.01）.Retain the success rate of fallopian tubes，tubal patency rate were significantly higher than the control group，the differences of the comparison were statistically significant（P<0.01）.The observation group and the control group in postoperative blood β-hCG returned to normal time，the incidence of persistent ectopic pregnancy，the differences of the comparison had no statistical significance（P>0.05）.Conclusion：Laparoscopic conservative surgery in tubal pregnancy with side palace angle of injection of Pituitrin can reduce intraoperative blood loss，shorten the operation time and improve the success rate of oviduct retain and postoperative tubal patency rate，safe and reliable operation and is worthy promoting.

【Key words】 Palace angle injection； Pituitrin； Tubal pregnancy； Laparoscopic conservative surgery

First-authors address：Pingxiang City Peoples Hospital，Pingxiang 532600，China

doi：10.14033/j.cnki.cfmr.2016.5.002

随着社会的发展与进步，人们的思想越来越开放，对性的态度也在不断发生着变化，婚前性行为年轻化，异位妊娠发生率呈逐年上升的趋势。异位妊娠是妇科常见的急腹症，诊治不及时则严重的威胁女性的身心健康，其发病率约2%[1]，其中以输卵管妊娠占绝大多数，在95%以上[2]，是早孕期间妇女死亡的主要原因[3]。目前，对大多数输卵管妊娠患者可在输卵管未破裂前做出诊断，因此使输卵管妊娠保守性手术成为可能，至今为止，国内外腹腔镜手术已是治疗异位妊娠的主要方法，与传统开腹手术相比具有创伤小、术后恢复快、术后并发症少等特点，但术中难以止血仍然是该方法最棘手及最关键的问题。……