压力水剥离在腹腔镜下妊娠输卵管线形切开手术中的应用

Application of pressure water in management of unruptured tube pregnancy by laparoscopic salpingostomy

目的 :探讨输卵管妊娠病人行腹腔镜下输卵管线形切开术时 ,妊娠组织物取出方式的临床价值。方法 :32例输卵管妊娠流产型病人行腹腔镜下输卵管线形切开术 ,妊娠组织物压力水剥离组 (第一组 ) 2 4例 ,妊娠组织物取出组 (第二组 ) 8例。结果 :两组手术均获成功。手术时间压力水剥离组 (2 8 9± 9 6 )min ,短于第二组 (5 6 2± 2 9 7)min(P =0 0 36 ) ;术中出血量压力水剥离组 (6 7± 2 9)ml,少于第二组 (31 8± 2 3 3)ml(P =0 0 18) ;肛门恢复排气时间压力水剥离组 (2 8 0± 7 6 )h ,同第二组 (2 8 5± 8 9)h(P =0 879) ;术后并发症压力水剥离组 (0 / 2 4 ) ,同第二组 (1/ 8) (P =0 5 5 7)。结论 :妊娠组织物压力水剥离是安全可行的 ,与取出组相比 ,手术时间短、出血少、手术操作简便 。

Objective:To evaluate the removed methods of the products of conception from unruptured tube pregnancy by laparoscopic salpingostomy. Methods: 32 women with unruptured tube pregnancy experienced laparoscopic linear salpingostomy. The products of conception were stripped and taken out of the tube with pressure water by means of irrigating solution in 24 ones(group one) of these subjects and extracted directly with laparoscopic forcep in 8 ones(group two). Results: All operations in both groups were performed successfully. The operative time in group one(28.9±9.6 min) was shorter than that in group two(56.2±29.7 min)(P<0.05), the amount of blood loss in group one(6.7±2.9 ml) was less than that in group two(31.8±23.3 ml) )(P<0.05), the time to the first flatus and postoperative morbidty in group one(28.0±7.6 h, 0/24) was as same as those in group two(28.5±8.9 h,1/8), respectively. Conclusion: The pressure water stripping of the product of conception is a safe and effective method for laparoscopic tube linear salpingostomy. It offers less blood loss, shorter operative time and simpler technique than the direct extraction with laparoscopic forcep.