腹腔镜手术治疗输卵管妊娠的临床观察

Laparoscopic surgery for tubal pregnancy

目的:探讨腹腔镜手术在治疗输卵管异位妊娠中的临床应用价值。方法:将我院经临床诊断为输卵管异位妊娠的82例患者,随机分为腹腔镜组52例和开腹手术组30例,比较两组手术时间、术中出血量、术后输卵管复通率及术后处理等情况。结果:本组中手术时间、手术方式、输卵管妊娠部位及血β-HCG下降,持续性输卵管妊娠情况腹腔镜组与开腹手术组比较差异无统计学意义(P<0.05);腹腔镜保守手术18例,输卵管通畅16例(88.9%),开腹保守手术9例,输卵管通畅3例(33.3%),两组比较差异有统计学意义(P<0.05);腹腔镜手术组术后6h可进半流饮食,第2天可进正常饮食,并可活动,术后第3天可拆线出院。开腹手术组术后3d后恢复饮食,5～7d方可拆线出院,两组比较差异有统计学意义(P<0.05)。腹腔镜手术组与开腹手术组均无术后并发症及死亡病例发生。结论:腹腔镜手术是治疗输卵管异位妊娠的一种理想的手术方式,值得推广。

Objective：To analyze the clinical effects of laparoscopic surgery for tubal pregnancy.Methods：A total of 82 patients with tubal pregnancy were randomly divided into laparoscopy group（52 cases） and laparotomy group（30 cases）.Duration of operation,blood loss,fallopian tubes were compared between the two groups.Results：There was no significant difference in duration of operation between the two groups;fallopian tubes were smooth in 16 of 18 patients in the laparoscopy group（88.9%）,the corresponding number was 3 out of 9 in the laparotomy group（33.3%）,indicating significant difference between the two groups（P〈0.05）.Patients that underwent laparoscopy can take semifluid food 6 hours after the surgery and normal diet 3 days later.Average length of hospital stay was 3 days;while 3 days after surgery can the laparotomy group took normal diet and their average hospital stay was 5-7 days,showing significant difference between the two groups（P〈0.05）.Neither complications nor death occurred.Conclusions：Laparotomy is a ideal treatment for tubal pregnency.