腹腔镜手术治疗异位妊娠的临床分析

Clinical analysis of minimally invasive laparoscopic treatment of ectopic pregnancy

目的:探讨腹腔镜手术治疗异位妊娠的临床疗效,评价临床应用价值。方法:回顾分析2007年1月至2009年2月为45例异位妊娠患者行腹腔镜手术的临床资料,随机选择同期行开腹手术的异位妊娠患者45例,比较两组手术时间、出血量、并发症、术后住院时间及术后妊娠率等。结果:腹腔镜组手术时间、术中出血量、术后镇痛药使用率、术后发热率明显低于开腹组(P<0.05),术后肛门排气时间、住院时间明显短于开腹组(P<0.05)。腹腔镜组再次妊娠成功率为62.86%,开腹组为62.16%(P>0.05)。两组患者术后并发症、输卵管通畅率、持续性异位妊娠等差异有统计学意义(P<0.05)。结论:腹腔镜手术治疗异位妊娠安全有效,并发症少,具有诊断和治疗的双重功效,可作为异位妊娠的首选术式。

Objective：To investigate the clinical efficacy of minimally invasive laparoscopic treatment of ectopic pregnancy,and assess its value in clinical application.Methods：A retrospective analysis was made on clinical data of 45 patients of ectopic pregnancy who underwent laparoscopic surgery from Jan.2007 to Feb.2009,45 patients with ectopic pregnancy who underwent laparotomy in our hospital during the same period were randomly selected as open group.The operative time,blood loss,complications,postoperative hospital stay and pregnancy were compared.Results：The operative time,operative blood loss,postoperative analgesia medication rate,and postoperative fever rate of laparoscopic group was significantly less than those of the laparotomy group（P0.05）,anal exhaust time and hospital stay was significantly shorter than the laparotomy group（P0.05）.The successful pregnancy rate in laparoscopic group was 62.86%,the rate was 62.16% in laparotomy group（P0.05）.Postoperative complications,tubal patency rate,persistent ectopic pregnancy and so on of 2 groups were significantly different（P0.05）.Conclusions：Laparoscopy is a safe and effective minimally invasive treatment for ectopic pregnancy,with fewer complications,diagnosis and treatment effect,which can be applied as the first operation choice for ectopic pregnancy.