腹腔镜保守性手术在休克型异位妊娠治疗中的效果及再妊娠结局分析

Analysis of effects and repregnancy outcomes of Laparoscopy Conservative operations on the patients with Hemorrhagic Shock due to Ectopic Pregnancy

目的探讨腹腔镜保守性手术在有生育要求的休克型异位妊娠治疗中的效果及再妊娠结局。方法回顾性分析142例行保守性手术治疗的有生育要求的异位妊娠患者，其中通过腹腔镜手术78例，开腹手术64例，比较两组手术时间，出血情况，术后排气时间，腹痛消失时间，住院天数，并随访输卵管通畅及受孕情况。结果腹腔镜组手术时间、排气时间、腹痛消失时间、住院天数均短于开腹组，差异具有统计学意义（P〈0．05）；两组术中出血、术后输卵管通畅情况之间差异无统计学意义（P〉0．05），腹腔镜组患者再妊娠率明显高于开腹组，差异具有统计学意义（P〈0．05）。结论腹腔镜治疗休克型异位妊娠患者是安全及可行的，并且能够显著提高再妊娠率。对于有生育要求的休克型异位妊娠患者，腹腔镜保守性手术应为首选。

Objective To explore the effects and repregnant outcomes of laparoscopy conservative operation on the patients with hemorrhagic shock due to ectopic pregnancy who desired for fertility. Methods The clinical data resulting from 142 patients with ectopic pregnancy treated by conservative operation were retrospec- tively analyzed, including 78 cases of laparoscopy and 64 cases of laparotomy, compared the operation time, blood loss, time of anus exsufflation, extinction time of abdominal pain, hospital days after operations, and followed up the uterine tube recanalization and androlepsis. Results The operation time, time of anus exsufflation, extinction time of abdominal pain, and hospital days after operations of laparoscopy were shorter than those of laparotomy, the differences had statistical significance（ P 〈 0. 05 ）. The differences of blood loss and uterine tube recanaliza- tion between the two groups didn＇ t have statistical significance （P 〉 0. 05 ）. The repreganancy rate of laparoseo- py was obviously higher than that of laparotomy, the difference had statistical significance （ P 〈 0. 05 ）. Conclu- sion Laparoscopic procedure is safe and feasible in management of patients with hemorrhagic shock due to ectopic pregnancy, and can raise the repregnancy rate. For those patients, the laparoscopy conservative operation was the first choice.