摘要
目的:对冷热器械下腹腔镜保守性输卵管妊娠手术的疗效和预后进行对比分析。方法:将200例输卵管妊娠保守性手术患者按术中应用冷热器械随机分为热器械组(输卵管创面单极电凝/双极电凝)和冷器械组(切缘缝扎/输卵管系膜/子宫动脉上行支缝扎止血)。比较两组手术耗时、住院时间、血清β-HCG恢复正常时间、持续性输卵管妊娠发生率,术后第二个月经周期进行经阴道三维超声造影检测患侧输卵管通畅情况。结果:热器械组手术时间(31.86±12)min,短于冷器械组(50.61±7.2)min(P<0.05);术中出血量(21.80±16)ml明显少于冷器械组(109.70±22)ml(P<0.01);术后β-HCG恢复正常的时间(16.29±4.8)d短于冷器械组(24.4±5.1)d(P<0.01);但术后患侧输卵管通畅比率低于冷器械组(P<0.01)。结论:热器械对于腹腔镜下输卵管妊娠保守性手术中止血效果和手术效果好于冷器械,但可能对输卵管结构和通畅性造成更明显的影响。
Objective:To compare the efficacy of laparoscopic conservative tubal pregnancy in cold and hot instruments.Methods:A total of 200 patients with tubal pregnancy were divided into cold instruments group(n=95)and thermal instruments group(n=105).The duration of operation,the intraoperative blood loss,the duration of postoperativeβ-HCG level down to normal,the incidence of persistent tubal pregnancy and the tubal patency measured by 3D-HyCoSy were observed and compared between two groups.Results:The average operation time(31.86±12)min in thermal instruments group wasshorter than that(50.61±7.2)min in the cold instruments group(P<0.05).The intraoperafive blood loss[(21.8±16)ml]in thermal instruments group was less than that[(109.7±22)ml]in cold instruments group(P<0.01).The duration of postoperativeβ-HCG level down to normal[(16.29±4.8)days]in thermal instruments group was shorter than that[(24.4±5.1)days]in cold instruments group(P<0.01).The cumulative patency rate in thermal instruments group was lower than that in cold instruments group(P<0.01).Conclusion:In laparoscopy oviduct-sparing operation,the thermal instruments hemostasis are better,but will do more damage to the oviduct.
作者
苏慧明
徐燕
刘焕玲
郭华
黎颖雄
郑敏旋
陈洁云
梁莹莹
SU Huiming;XU Yan;LIU Huanling(Guangzhou Panyu Central Hospital,Guangzhou 511400)
出处
《陕西医学杂志》
CAS
2020年第2期151-153,共3页
Shaanxi Medical Journal
基金
广东省广州市医药卫生科技项目(20161A010113)
关键词
输卵管妊娠
冷器械
热器械
输卵管通畅性
三维经阴道超声造影
腹腔镜检查
Fallopian tube pregnancy
Cold instruments
Thermal instruments
Tubal Patency
3D-hysterosalpingo-contrast sonography
Laparoscopy
