腹腔镜手术与剖腹手术治疗卵巢妊娠的对照研究及临床分析

Contrast study and clinical analysis of ovarian pregnancy by laprectomy and laparoscopy operation

目的:分析44例卵巢妊娠的临床特征,探讨腹腔镜手术治疗卵巢妊娠的可行性与安全性。方法:对我院1996～2004年的44例卵巢妊娠进行回顾性研究。将行腹腔镜手术治疗的24例卵巢妊娠为研究组,行剖腹手术治疗的20例卵巢妊娠为对照组,分析两组患者的围手术期情况。结果:44例卵巢妊娠全部行急诊手术治疗,术中所见全部发生破裂,占同期异位妊娠总数的2.06%,发生率呈逐年上升趋势。临床特征为腹痛明显,无明显停经史,研究组手术时间及术中出血量明显少于剖腹手术组(P<0.01),静脉用抗生素时间、肛门排气时间及住院时间明显短于剖腹手术组(P<0.01),住院费用明显多于剖腹手术组(P<0.01)。结论:卵巢妊娠的发生可能与盆腔炎症,IUD有关,对于卵巢妊娠行腹腔镜手术治疗是安全、可行、值得推广的。

Objective:To analyze clinical manifestation of 44 cases of ovarian pregnancy and explore the possibility and safty of laparoscopy therapy to the disease.Methods:44 cases of ovarian pregnancy patients in hospital from 1996 to 2004 were studied retrospectively.24 cases were treated by laparoscopy as the study group and 20 cases were treated by laprectomy as contrast in random.Clinical manifestation of the 44 patients were analyzed.Results:All the 44 cases were treated by emergency operation in which ovarian rupture were found.The morbility of ovarian pregnancy is 2.06% of all the ectopic pregnancy with an increasing trend.The clinical manifestation of all the 44 cases showed severe abdominal pain and menopause.Operation time and blood loss were less in the laparoscopy group than those in the contrast(56±24 and 76±34 minutes,23±12 and 78±39 ml,P<0.01).Intravenous antibiotics days and in hospital time were less in study group than those in contrast(2.74±2.1, 6.21±2.19 days,P<0.01).The cost is higher in study group than in contrast(6 874±475,5 560±292 yuan,P<0.01).Conclusion:Ovarian pregnancy occurence are related to pelvic inflammation and IUD.Laparoscopy therapy of ovarian pregnancy was a safe and effective method and sould be promoted in the future.