小剂量垂体后叶素在腹腔镜下输卵管妊娠保守性手术中的应用价值

目的：探讨小剂量垂体后叶素在腹腔镜下输卵管妊娠保守手术中的应用价值。方法：回顾性分析在金华市妇幼保健院确诊为输卵管妊娠并行腹腔镜下切开取胚术的124例患者，根据手术方法的不同分为2组：研究组63例，术中行输卵管切开前于着床部位输卵管系膜处注射垂体后叶素2 U；对照组61例，术中行常规腹腔镜下输卵管切开取胚术。观察2组手术时间、术中出血量、术后持续性异位妊娠发生率、术后患侧输卵管通畅率、术后妊娠率及术后异位妊娠率。结果：研究组手术时间为（47.0±7.5）min，短于对照组的（58.7±7.9）min（P＜0.01）；术中出血量为（17.3±7.3）mL，少于对照组的（41.0±9.1）mL（P＜0.01）；持续性异位妊娠发生率为1.5%，低于对照组的3.3%（P＜0.05）；术后输卵管通畅率为55.6%，高于对照组的34.4%（P＜0.05）；术后不避孕1年内的妊娠率为46.6%，高于对照组的31.6%（P＜0.01）；异位妊娠率为1.7%，低于对照组的7.0%（P＜0.05）。结论：输卵管妊娠着床部位输卵管系膜处小剂量垂体后叶素注射后行腹腔镜下输卵管切开取胚术能显著减少术中出血，降低持续性异位妊娠的发生，保护术后患侧输卵管功能，提高术后妊娠率。

The value of small dose pituitrin in conservative laparoscopic surgery for ectopic pregnancy

Objective: To investigate the value of small dose of pituitrin administered in conservative laparoscopic surgery for ectopic pregnancy. Methods: A total of 124 patients who were confirmed with ectopic pregnancy and underwent laparoscopic tubal incision were reviewed retrospectively in Jinhua Maternal and Childcare Hospital. Sixty-three patients included in the study group received injection of 2 U pituitrin into mesosalpinx at the implantation site intraoperatively; Sixty-one patients in the control group underwent routine laparoscopic tubal incision without pituitrin injection during the operation. The operation time, intraoperative blood loss, postoperative persistent ectopic pregnancy rate, postoperative uterine fallopian tube angiography, postoperative pregnancy rate and postoperative ectopic pregnancy rate were observed. Results: The operation time of the study group was (47.0±7.5) min, significantly shorter than that in the control group (58.7±7.9)min] (P<0.01). The intraoperative blood loss in the study group was (17.3±7.3)mL, significantly less than the control group (41.0±9.1)mL] (P<0.01); the incidence of persistent ectopic pregnancy (1.5%) in the study group was lower than that of the control group (3.3%) (P<0.05); the postoperative fallopian tube patency rate (55.6%) was higher than the control group (34.4%) (P<0.05) and the pregnancy rate within 1 year after surgery was significantly higher in the study group (46.6%) than that in the control group (31.6%) (P<0.01), while the ectopic pregnancy rate in the study group (1.7%) was lower than that in the control group (7.0%) (P<0.05). Conclusion: Laparoscopic fallopian tube incision after small dose of pituitary vasopressin at the oviduct pregnancy site of the tubal pregnancy could significantly reduce intraoperative bleeding, reduce the incidence of persistent ectopic pregnancy, protect postoperative fallopian tube function and improve postoperative pregnancy rate.