急诊腹腔镜治疗出血性宫外孕202例临床分析

Management of 202 cases of ectopic pregnancy with intra-abdominal bleeding by emergency laproscopic operation.

目的 探讨急诊腹腔镜治疗出血性宫外孕的可能性、优越性。方法回顾分析1998年8月～2005年10月急诊腹腔镜出血性宫外孕402例，随机分为腹腔镜组202例，开腹组200例。比较两组手术时间、并发症、术后病率、术后输卵管通畅情况。结果腹腔镜比开腹手术住院时间短、术后恢复快、并发症少、术后病率少。手术时间，腹腔镜组（1998年8月～2001年12月）比开腹手术组长，（2002年1月～2005年10月）短于开腹组，结论腹腔镜手术应用于急腹症出血性宫外孕，当休克早期，在抗休克的同时行腹腔镜手术较安全、有效，病人术后恢复快、不增加并发症，更适应有生育要求患者。

Objective： To explore the possibility and advantages in clinical management of hemorrhagic ectopic pregnancy by emergency laproseople operation. Methods： Four hundred and two （402） eases of eetopie pregnancy with intra-abdominal bleeding were recruited in our research August of 1998 to 2005. The patients were divided into two groups randomly. Two hundred and two （202） eases were in the laparoseopie group, while 200 in laparotomy group, parameters including operating time, complications, post-operative mobility and fallopian tube pateney were collected for comparison. Results： It showed that eases managed by laparoscopy need in-patient time. Also, the group of patients bad less complications and less post- operative mobility. Time for Laparoseopie procedure was longer than laparotomy between January 1998 and December 2001. However, it was much less between January 2002 and October 2005. Conclusion ： Laparoseopy can be applied in management of emergency eetopie pregnancy with intra-abdominal bleeding. Anti-shock treatment also should be thought about in any ease in early stage of shock. Laparoseopie procedure was safe and effective in management of these patients. They may experience a less complication post- operative recovery. The procedure specially was beneficial for the patient who expecting future normal pregnancy.