腹腔镜用于异位妊娠121例分析

Analysis of 121 patients of ectopic pregnancy diagnosed and treated by laparoscopy

目的 探讨腹腔镜在异位妊娠治疗中的适应证、术式选择、并发症的防治以及临床应用价值。方法 将确诊为异位妊娠有手术指征的 ,采用腹腔镜手术的患者 12 1例为实验组 ,采用开腹手术的异位妊娠 94例为对照组 ,回顾性分析比较两组的手术情况和术后情况。结果 实验组手术时间 (5 2 .2 1± 10 .34)min ,对照组手术时间 (5 1.73± 11.0 7)min(P <0 .0 5 ) ,无差异性 ;实验组术中出血量为 (2 0 .0 9± 5 .2 1)ml,对照组术中出血量为 (41.4 1± 4 .6 3)ml,具有显著差异性 ;实验组术后离床时间为 (1.2 8±0 .4 0 )d ,对照组术后离床时间为 (2 .92± 0 .5 4 )d(P <0 .0 5 ) ,具有显著差异性 ;实验组术后 2d体温 >37℃ 10例 ,占 8.2 6 % ,对照组19例 ,占 2 0 .2 1% (P <0 .0 5 ) ,具有显著差异性 ;实验组平均住院天数 (4.5 4± 0 .6 7)d ,对照组为 (7.5 7± 0 .81)d(P <0 .0 5 ) ,具有显著差异性。结论 腹腔镜手术创伤小 ,恢复快 ,术中出血少 ,住院时间短 ,是治疗异位妊娠首选的手术方式。但要注意手术适应证的选择 ,术中对止血不满意时 ,应果断中转开腹。

Objective To explore the value of laparoacopy in the management of ectopic pregnancy.Methods One hundred and twenty-one patients with ectopic pregnancy were diagnosed and treated by laparoscopy. Intraabdominal operation were performed in 94 cases with ectopic pregnancy. All cases were reviewed and analyzed.Results The operation time was (52.21±10.34) min in the test group and (51.73±11.07)min in the control group, P>0.05,there was no statistically significant difference; the operation bleeding volume was (20.09±5.21)ml in the test group and (41.41±4.63)ml in the control group, P<0.05,there was statistically significant difference; the off time-bed after operation was (1.28±0.40) days in the test group and (2.92±0.54)days in the control group, P<0.05, difference was statistically significant; there were 10 patients′ temperature >38℃ two day after operation in the test group(8.26%) and 19 cases in the control group(20.21%), P<0.05, showed statistically significant difference; the two groups had statistically significant difference in hospital stay, that was (4.54±0.67) days in the test group and (7.57± 0.81 )days in the control group, P<0.05.Conclusion Laparoscopic operation provides a safe and efficient minimally invasive method for ectopic pregnancy .However, the choice of indication should be pay more attention and intraabdominal operation should be performed when it is very difficult to control the bleeding.