腹腔镜下单极轻微电凝输卵管浆膜层止血在宫外孕保守手术中的应用

摘要

目的 探讨腹腔镜下单极轻微电凝输卵管浆膜层止血在异位妊娠(Ectopic pregnancy,EP)保守手术中的临床效果.方法 将86例异位妊娠患者按照数字表法随机分为两组,对照组43例采取腹腔镜下止血方法治疗;观察组43例给予腹腔镜下开窗前先用单极呈轻微电凝输卵管浆膜层止血术治疗,并比较两组的临床效果.结果 观察组手术时间[(27.82±11.46) min比(44.75±17.69) min]、手术出血量[(11.69±3.58) ml比(40.64±8.71) ml]均显著地低于对照组(P＜0.05),观察组输卵管保留成功率明显高于对照组(93.02％比83.72％,P＜ 0.05),观察组总通畅率而显著高于对照组(81.40％比62.79％,P＜0.05).结论 腹腔镜下开窗前先用单极呈轻微电凝输卵管浆膜层止血,能够减少手术出血量,视野清晰,缩短手术时间、方法简单、有效、安全.术后患者输卵管功能恢复好,有效地提高了患者恢复生育功能.%Objective To investigate the clinical effect of laparoscopic slight monopolar electrocoagulation tubal serosa hemostasis in conservative surgery of ectopic pregnancy (EP).Methods 86 cases of ectopic pregnancy were randomly divided into two groups,43 cases in the control group were given laparoscopic hemostasis methods,43 cases in the observation group were given laparoscopic slight monopolar electrocoagulation tubal serosa hemostasis before fenestration.The clinical effects were compared between the two groups.Results The operation time,bleeding volume in the observation group were significantly lower than those in the control group [(27.82±11.46)min vs.(44.75±17.69)min,(11.69±3.58)ml vs.(40.64±8.71)ml;P＜0.05].The success rate of fallopian tube retention in the observation group was significantly higher than that in the control group (93.02％ vs.83.72％,P＜0.05).The total patency rate in the observation group was significantly higher than that in the control group (81.40％ vs.62.79％,P＜0.05).Conclusions Laparoscopic slight monopolar electrocoagulation tubal serosa hemostasis before fenestration can reduce the amount of bleeding,shorten the operation time,with clear visual field,is a kind of simple,effective,and safe method.The fallopian tube function of patients recovers well after surgery,which effectively improves the recovery of fertility in patients.