子宫角妊娠手术中宫角缝合与不缝合对术后生育能力的对比研究  

A Comparative Study on Postoperation Fertility of Cornual Suture and Non-suture in the Operation of Cornual Pregnancy

作　　者：王细拉[1] 吴丽芳 叶春杰 刘仙[1] WANG Xila;WU Lifang;YE Chunjie;LIU Xian(People’s Liberation Army Joint Service Support Unit 908 Hospital,Yingtan 335000,China;不详)

机构地区：[1]中国人民解放军联勤保障部队第九〇八医院,江西鹰潭335000 [2]江西省鹰潭市人民医院 [3]江西省鹰潭市中医院

出　　处：《中国医学创新》2019年第36期114-117,共4页Medical Innovation of China

基　　金：鹰潭市2018年市级科技指导性计划（社发类）项目（Ykz20180025）

摘　　要：目的:对比研究子宫角妊娠手术中宫角缝合与不缝合对术后生育能力的影响。方法:回顾性分析2015年1月-2018年5月本院收治的子宫角妊娠65例患者的资料,均进行腹腔镜下子宫角部切开取胚术治疗,根据止血方式的不同分为两组:宫角缝合组(子宫角修补术,n=34)与压迫止血组(吸收性明胶海绵压迫止血,n=31)。分析两组围手术期临床资料及术后3个月复查结果,并对术后1年的生育情况进行随访,比较两组术后生育能力的差异。结果:两组术中出血量、输卵管创面止血时间和β-hCG降至正常的时间比较,差异均无统计学意义(P>0.05);术后3个月复查,两组输卵管梗阻情况比较,差异无统计学意义(P>0.05)。随访至治疗后1年,压迫止血组再妊娠率高于宫角缝合组(P<0.05),而两组再次异位妊娠率比较,差异无统计学意义(P>0.05)。结论:腹腔镜下切开取胚术对子宫角妊娠进行治疗时,吸收性明胶海绵压迫止血不会影响手术疗效和增加出血风险,且更有利于患者术后生育能力的恢复,值得临床普及推广。Objective:To compare the effects of cornual suture and non-suture on the postoperation fertility of cornual pregnancy.Method:A retrospective analysis was made on 65 cases of cornual pregnancy treated in our hospital from January 2015 to May 2018.All of them underwent laparoscopic corneal incision and embryo extraction.They were divided into cornual suture group(repair of uterine horn,n=34)and compression hemostasis group(hemostasis by compression of absorbable gelatin sponge,n=31)according to different hemostasis methods.The perioperative clinical data and 3-month follow-up results of two groups were analyzed,and the fertility of two groups was followed up for 1 year.The differences of fertility between two groups were compared.Result:There were no significant differences in the amount of bleeding during operation,the time of stopping bleeding of fallopian tube wound and the time of decreasingβ-hCG to normal value between two groups(P>0.05).There was no significant difference in the situation of fallopian tube obstruction between two groups after 3 months of operation(P>0.05).Follow-up to 1 year after treatment,the repregnancy rate of compression hemostasis group was higher than that of cornual suture group(P<0.05),while there was no significant difference in the rate of ectopic pregnancy between two groups(P>0.05).Conclusion:When using laparoscopic embryotomy to treat cornual pregnancy patients,absorbable gelatin sponge compression hemostasis will not affect the efficacy of surgery and increase the risk of bleeding,and is more conducive to the recovery of fertility after surgery,which is worthy of clinical popularization.

关 键 词：子宫角妊娠 术后生育能力 宫角缝合 压迫止血 

分 类 号：R713.8[医药卫生—妇产科学]