腹腔镜下治疗休克型异位妊娠11例临床分析

Laparoscopic surgery in patients with hypovolemic shock due to ectopic pregnancy(report of 11 cases)

目的探讨腹腔镜下治疗休克型异位妊娠的有效性及安全性。方法回顾性分析该院2000年4月￣2004年7月收治的经腹腔镜手术治疗的休克型异位妊娠11例病例的临床资料,探讨手术治疗效果。结果异位妊娠破裂率为81.8%,流产率为18.2%,腹腔内出血量为800￣1200mL;11例中行输卵管切除术9例,行输卵管开窗取胚术2例。术中输血6例,输血量400￣800mL。手术时间约60min,其中间质部妊娠稍长,约60￣85min;术后平均住院时间4d。结论具备熟练的腹腔镜操作技术,合适的麻醉,先进的心电监护设备,必要的支持疗法,腹腔镜下治疗休克型异位妊娠是安全和有效的。

[Objective] To evaluate the feasibility and safety of operative laparoscopy for ectopic pregnancy with hypovolemic shock. [Methods] 11 cases of operative laparoscopy for ectopic pregnancy with hypovolemie shock in our hospital retrospectively were analyses. [Results] In our study, 11 patients underwent laparoscopie operations successfully. The rate of tube rupture was 81.8%, and the rate of abortion was 18.2%; Intraabdominal blood loss were 800-1 200 mL. 9 cases underwent laparoscopic salpingectomy, and 2 cases underwent salpingotomy. Blood transfusions were given to 6 patients, and transfusion were 400-800 mL. Mean operation duration was 60 min, in which the time of pregnancy in interstitial portion fallopian tube was 60-85 min. Mean duration of post-operation in hospital was 4 days. [ Conclusions] Operative laparoscopy in patients with hypovolemie shock can be safely and effectively performed by experienced laparoscopists with the aid of optimal anesthesia, advauced cardiovascular monitoring.