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目的探讨减少输卵管间质部妊娠腹腔镜术中失血的方法。方法选择2007年1月2010年6月49例诊断为输卵管间质部妊娠的患者随机分成观察组(24例)和对照组(25例)。观察组在腹腔镜切开异位妊娠病灶前于宫角注射垂体后叶素6 U,待子宫收缩后手术;对照组直接切开异位妊娠病灶进行手术。比较两组手术时间、术中出血量、血压、术后肛门排气时间、体温等方面的差异以及随访患者月经恢复时间。结果观察组和对照组手术时间分别为(34.29±7.96)、(53.68±10.48)min,术中出血量为(48.04±9.49)、(85.52±15.24)mL,差异有统计学意义(P<0.05);两组在术后肛门排气时间、术后体温、术前血压、妊娠病灶切开后5 min的血压以及观察组使用垂体后叶素前后的血压差异均无统计学意义(P>0.05)。两组患者在术后30~41 d月经复潮。结论输卵管间质部妊娠腹腔镜术中使用垂体后叶素能明显缩短手术时间和减少术中出血量,不增加持续性宫外孕的发生。
Objective To explore the method of reducing blood loss in tubal pregnancy during laparoscopic pregnancy. Methods A total of 49 patients with tubal pregnancy diagnosed as January 2007 and June 2010 were randomly divided into observation group (24 cases) and control group (25 cases). Observation group before laparoscopic ectopic pregnancy incision in the uterine injection of pituitary vasopressin 6 U, to be uterine contractions after surgery; control group directly cut ectopic pregnancy lesions for surgery. The operative time, intraoperative blood loss, blood pressure, postoperative anal exhaust time, body temperature and other differences and follow-up of patients with menstruation recovery time were compared. Results The operative time of the observation group and the control group were (34.29 ± 7.96) and (53.68 ± 10.48) min respectively, and the intraoperative blood loss was (48.04 ± 9.49) and (85.52 ± 15.24) mL, respectively, with significant difference ). There was no significant difference between the two groups in postoperative anal exhaust time, postoperative body temperature, preoperative blood pressure, blood pressure 5 min after incision of pregnancy and blood pressure in observation group before and after pituitrin (P> 0.05 ). Two groups of patients in the postoperative 30 ~ 41 d menstrual cramps. Conclusion The use of pituitrin in laparoscopic tubal interstitial pregnancy can significantly shorten the operation time and reduce intraoperative blood loss, does not increase the occurrence of persistent ectopic pregnancy.