CAJ | 학술논문

目的：探讨腹腔镜下输卵管切开取胚术联合垂体后叶素治疗输卵管妊娠的临床效果。方法选取输卵管妊娠患者共160例，采用随机数字表法分为对照组和治疗组，每组各80例；对照组采用腹腔镜下输卵管切开取胚术，治疗组则在对照组基础上术前给予垂体后叶素应用；比较两组手术时间、术中出血量、术后体温、住院时间、术后输卵管保留率、患侧输卵管通畅率、持续性异位妊娠率、宫内妊娠率及不孕率等。结果对照组手术时间、术中出血量、术后体温及住院时间分别为（20．33±2．70）min、（52．76±7．42）mL、（37．52±0．54）℃、（7．56±1．98）d，治疗组手术时间、术中出血量、术后体温及住院时间分别为（8．94±1．61）min、（16.33±2．15）mL、（37．46±0．50）℃、（5．91±1．42）d，治疗组手术时间、术中出血量及住院时间均显著优于对照组（t＝2．26、2．60、2．08，均P＜0．05），两组术后体温差异无统计学意义（t＝1．55，P＞0．05）；对照组术后输卵管保留率和患侧输卵管通畅率分别为75．00％（60／80）、52．50％（42／80），治疗组术后输卵管保留率和患侧输卵管通畅率分别为93．75％（75／80）、81．25％（65／80），治疗组术后输卵管保留率和患侧输卵管通畅率均显著高于对照组，差异有统计学意义（χ2＝9．71、10．14，均P＜0．05）；对照组持续性异位妊娠率、宫内妊娠率及不孕率分别为17．50％（14／80）、31．25％（25／80）、37．50％（30／80），治疗组持续性异位妊娠率、宫内妊娠率及不孕率分别为15．00％（12／80）、61．25％（49／80）、16．25％（13／80），两组持续异位妊娠率差异无统计学意义（χ2＝1．33，P＞0．05）；治疗组宫内妊娠率和不孕率均显著优于对照组，差异有统计学意义（χ2＝11．84、12.52，均P＜0．05）。结论腹腔镜下输卵管切开取胚术联合垂体后叶素治疗输卵管妊娠可有效减少手术时间和术中出血量，缩短住院时间，并有助于改善生殖结局，具有临床应用价值。目的：探討腹腔鏡下輸卵管切開取胚術聯閤垂體後葉素治療輸卵管妊娠的臨床效果。方法選取輸卵管妊娠患者共160例，採用隨機數字錶法分為對照組和治療組，每組各80例；對照組採用腹腔鏡下輸卵管切開取胚術，治療組則在對照組基礎上術前給予垂體後葉素應用；比較兩組手術時間、術中齣血量、術後體溫、住院時間、術後輸卵管保留率、患側輸卵管通暢率、持續性異位妊娠率、宮內妊娠率及不孕率等。結果對照組手術時間、術中齣血量、術後體溫及住院時間分彆為（20．33±2．70）min、（52．76±7．42）mL、（37．52±0．54）℃、（7．56±1．98）d，治療組手術時間、術中齣血量、術後體溫及住院時間分彆為（8．94±1．61）min、（16.33±2．15）mL、（37．46±0．50）℃、（5．91±1．42）d，治療組手術時間、術中齣血量及住院時間均顯著優于對照組（t＝2．26、2．60、2．08，均P＜0．05），兩組術後體溫差異無統計學意義（t＝1．55，P＞0．05）；對照組術後輸卵管保留率和患側輸卵管通暢率分彆為75．00％（60／80）、52．50％（42／80），治療組術後輸卵管保留率和患側輸卵管通暢率分彆為93．75％（75／80）、81．25％（65／80），治療組術後輸卵管保留率和患側輸卵管通暢率均顯著高于對照組，差異有統計學意義（χ2＝9．71、10．14，均P＜0．05）；對照組持續性異位妊娠率、宮內妊娠率及不孕率分彆為17．50％（14／80）、31．25％（25／80）、37．50％（30／80），治療組持續性異位妊娠率、宮內妊娠率及不孕率分彆為15．00％（12／80）、61．25％（49／80）、16．25％（13／80），兩組持續異位妊娠率差異無統計學意義（χ2＝1．33，P＞0．05）；治療組宮內妊娠率和不孕率均顯著優于對照組，差異有統計學意義（χ2＝11．84、12.52，均P＜0．05）。結論腹腔鏡下輸卵管切開取胚術聯閤垂體後葉素治療輸卵管妊娠可有效減少手術時間和術中齣血量，縮短住院時間，併有助于改善生殖結跼，具有臨床應用價值。
목적：탐토복강경하수란관절개취배술연합수체후협소치료수란관임신적림상효과。방법선취수란관임신환자공160례，채용수궤수자표법분위대조조화치료조，매조각80례；대조조채용복강경하수란관절개취배술，치료조칙재대조조기출상술전급여수체후협소응용；비교량조수술시간、술중출혈량、술후체온、주원시간、술후수란관보류솔、환측수란관통창솔、지속성이위임신솔、궁내임신솔급불잉솔등。결과대조조수술시간、술중출혈량、술후체온급주원시간분별위（20．33±2．70）min、（52．76±7．42）mL、（37．52±0．54）℃、（7．56±1．98）d，치료조수술시간、술중출혈량、술후체온급주원시간분별위（8．94±1．61）min、（16.33±2．15）mL、（37．46±0．50）℃、（5．91±1．42）d，치료조수술시간、술중출혈량급주원시간균현저우우대조조（t＝2．26、2．60、2．08，균P＜0．05），량조술후체온차이무통계학의의（t＝1．55，P＞0．05）；대조조술후수란관보류솔화환측수란관통창솔분별위75．00％（60／80）、52．50％（42／80），치료조술후수란관보류솔화환측수란관통창솔분별위93．75％（75／80）、81．25％（65／80），치료조술후수란관보류솔화환측수란관통창솔균현저고우대조조，차이유통계학의의（χ2＝9．71、10．14，균P＜0．05）；대조조지속성이위임신솔、궁내임신솔급불잉솔분별위17．50％（14／80）、31．25％（25／80）、37．50％（30／80），치료조지속성이위임신솔、궁내임신솔급불잉솔분별위15．00％（12／80）、61．25％（49／80）、16．25％（13／80），량조지속이위임신솔차이무통계학의의（χ2＝1．33，P＞0．05）；치료조궁내임신솔화불잉솔균현저우우대조조，차이유통계학의의（χ2＝11．84、12.52，균P＜0．05）。결론복강경하수란관절개취배술연합수체후협소치료수란관임신가유효감소수술시간화술중출혈량，축단주원시간，병유조우개선생식결국，구유림상응용개치。
Objective To investigate clinical effects of laparoscopic salpingotomy combined with pituitrin in the treatment of tubal pregnancy.Methods 160 children with tubal pregnancy were chosen in our hospital in the period and randomly divided into two groups including control group (80 children)with laparoscopic salpingotomy treatment and treatment group (80 children)with pituitrin adjunct treatment before operation on the basis of control group.And the operation time,intraoperative bleeding volume,postoperative body temperature,hospitalization time,the retention rate of fallopian tube,fallopian tube patency rate,persistent ectopic pregnancy rate,intrauterine pregnancy rate and fertility rate of both groups were compared.Results The operation time,intraoperative bleeding volume, postoperative body temperature and hospitalization time of the control group were separately (20.33 ±2.70)min, (52.76 ±7.42)mL,(37.52 ±0.54)℃ and (7.56 ±1.98)d;the operation time,intraoperative bleeding volume, postoperative body temperature and hospitalization time of the treatment group were separately (8.94 ±1.61)min, (16.33 ±2.15)mL,(37.46 ±0.50)℃and (5.91 ±1.42)d;the operation time,intraoperative bleeding volume and hospitalization time of the treatment group were significantly better than those of the control group (t=2.26,2.60, 2.08,all P<0.05 );there was no significant difference in postoperative body temperature between 2 groups (t=1.55,P>0.05).The retention rate of fallopian tube and fallopian tube patency rate of the control group were sepa-rately 75.00% (60/80)and 52.50%(42/80);the retention rate of fallopian tube and fallopian tube patency rate of the control group were separately 93.75% (75/80)and 81.25% (65/80);the retention rate of fallopian tube and fallopian tube patency rate of treatment group were significantly better than those of the control group (χ2 =9.71, 10.14,all P<0.05).The persistent ectopic pregnancy rate,intrauterine pregnancy rate and fertility rate of the control group were separately 17.50%(14/80),31.25%(25/80)and 37.50%(30/80);the persistent ectopic pregnancy rate,intrauterine pregnancy rate and fertility rate of the treatment group were separately 15.00% (12/80),61.25%(49/80)and 16.25% (13/80);there was no significant difference in persistent ectopic pregnancy rate between 2 groups (χ2 =1.33,P>0.05);the intrauterine pregnancy rate and fertility rate of treatment group were significant-ly better than those of the control group (χ2 =11.84,12.52,all P<0.05).Conclusion Laparoscopic salpingotomy combined with pituitrin in the treatment of tubal pregnancy can efficiently decrease operation time the amount of bleeding,shorten hospitalization time and be helpful to improve the reproductive outcome.