Objective To assess the effectiveness and safety of traditional Chinese medicinal herbs for subfertility. Method Databases used including MEDLINE, EMBASE, CBM and the Cochrane Controlled Trial Register (CCTR). Potentially related trials in reference lists of studies were hand searched. Published RCTs in any languages and length whether they were blind or unblind, were included. Treatments were Chinese medicinal herbs (single or compound), and controls were placebo, standard medical intervention, or no intervention. Data were extracted independently by two reviewers and analyzed with Revman 4.2 softeware. Results 7 randomized trials, including 1 042 patients met inclusion criteria. Methodological quality of all trials was poor. Chinese medicinal herbs were effective compared with routine antibiotics [RR 1.49, 95％CI (1.37 to1.62), Plt;0.000 01] and resulted in higher pregnancy rate [RR 1.46, 95%CI (1.09 to,1.96), P=0.01]. There were no adverse events reported in treatment group. Conclusions Some Chinese medicinal herbs may be effective for subfertility. However, the evidence is too weak to draw a conclusion. More strictly designed, randomized, double-blind, placebo-controlled trials are required.
Objective To study the clinical value and surgical procedure of laparoscopic operation for interstitial tubal pregnancy. Methods Clinical data of 36 patients of interstitial tubal pregnancy treated by laparoscopic operation were retrospectively analyzed. Results All 36 patients were operated successfully, without conversions to laparotomy and intra- or post- operative complications. The operation time was 28-85 min(mean, 41min), and the length of stay in hospital postoperative was 3-6 d (mean, 4-5 d). Conclusion Laparoscopic operation for interstitial tubal pregnancy is safe and feasible.
【摘要】 目的 探讨减少输卵管间质部妊娠腹腔镜术中失血的方法。 方法 选择2007年1月-2010年6月49例诊断为输卵管间质部妊娠的患者随机分成观察组（24例）和对照组（25例）。观察组在腹腔镜切开异位妊娠病灶前于宫角注射垂体后叶素6 U，待子宫收缩后手术；对照组直接切开异位妊娠病灶进行手术。比较两组手术时间、术中出血量、血压、术后肛门排气时间、体温等方面的差异以及随访患者月经恢复时间。 结果 观察组和对照组手术时间分别为（34.29±7.96）、（53.68±10.48） min，术中出血量为（48.04±9.49）、（85.52±15.24） mL，差异有统计学意义（Plt;0.05）；两组在术后肛门排气时间、术后体温、术前血压、妊娠病灶切开后5 min的血压以及观察组使用垂体后叶素前后的血压差异均无统计学意义（Pgt;0.05）。两组患者在术后30～41 d月经复潮。 结论 输卵管间质部妊娠腹腔镜术中使用垂体后叶素能明显缩短手术时间和减少术中出血量，不增加持续性宫外孕的发生。【Abstract】 Objective To explore the method of reducing bleeding in laparoscopy for interstitial pregnancy. Methods Forty-nine patients diagnosed to have interstitial pregnancy between January 2007 and June 2010 were randomly divided into observation group (24 cases) and control group (25 cases). Patients in the observation group were given an injection of 6 U pituitrin in the horn of uterus before the incision of lesions in laparoscopy, and operation was performed after uterine contraction; while the lesions of patients in the control group were directly incised. The differences between the two groups in operation time, blood loss during the operation, blood pressure, exhaust time and temperature were studied and the recovery time of menstrual period was followed up. Results The operation time of the observation group and the control group was (34.29±7.96) minutes and (53.68±10.48) minutes; the blood loss was (48.04±9.49) mL and (85.52±15.24) mL, respectively. The difference in the operation time and blood loss between the two groups was significant (Plt;0.05). The difference in other indexes between the two groups such as the exhaust time, postoperative body temperature, the blood pressure before operation and within five minutes after the incision of the lesion was not statistical (Pgt;0.05). The recovery time of menstrual period in the two groups was 30 to 41 days. Conclusion Using pituitrin in laparoscopy for interstitial pregnancy can significantly shorten operation time and reduce blood loss, and will not increase the incidence rate of persistent ectopic pregnancy.