妊娠期腹腔镜手术治疗可行性分析

The analysis of the feasibility of laparoscopic operation in gestation

目的探讨妊娠期腹腔镜手术治疗可行性。方法回顾分析福建医科大学附属漳州市医院于2006年6月～2011年5月对20例妊娠合并卵巢良性肿瘤患者实施腹腔镜下卵巢瘤剔除术(腹腔镜组);对照组18例妊娠合并卵巢良性肿瘤患者实施腹式卵巢瘤剔除术(开腹组)进行分析。结果手术时间腹腔镜组(42.62±8.12)min,开腹组(55.35±5.23)min,两组比较差异有统计学意义(P<0.01);出血量腹腔镜组(30.25±7.58)mL,开腹组(35.00±8.35)mL,两组比较差异有统计学意义(P<0.05);术后排气时间腹腔镜组(20.56±7.48)h较开腹组的(46.79±4.52)h明显缩短,差异有统计学意义(P<0.01);术后下床时间腹腔镜组(21.37±5.21)h早于开腹组的(34.75±6.62)h,两组比较差异有统计学意义(P<0.01),术后住院日腹腔镜组(3.12±1.05)d明显短于开腹组的(6.15±1.34)d,比较差异有统计学意义(P<0.01)。两组病例妊娠均维持至足月,新生儿出生体质量和阿氏评分均未发现异常。结论妊娠期腹腔镜手术对母体胎儿是安全可行的,是最小的侵入性手术。把握合适的手术时机,由经验丰富的妇科内镜医师完成是保证母婴安全的重要因素。

Objective To investigate the feasibility of laparoscopic operation in gestetion.Methods Use retrospective analysis to analyze 20 cases of pregnancy merge ovarian benign tumor that use celioscope to take abdominal type oothecoma myomectomy as（celioscope team）,18 cases that take abdominal type oothecoma myomectomy as control team（celiotomy team）.Results operation time of celioscope team is（42.62±8.12） min,celiotomy team is（55.35±5.23） min,the comparison has significant deviation（P0.01）;amount of bleeding of celioscope team is（30.25±7.58） mL,celiotomy team is（35.00±8.35） mL（P0.05）;venting time of celioscope team is 20.56±7.48 h,celiotomy team is（46.79±4.52） h（P0.01）;the time of leave bed of celioscope team is（21.37±5.21） h,celiotomy team is（34.75±6.62） h（P0.01）,hospitalization time of celioscope team is（3.12±1.05） d,celiotomy team is（6.15±1.34） d（P0.01）,the two teams of patients all maintain pregnancy to full term,and the birth weight and apgar score of neonatus are all normal.Conclusion Aparoscopic operation in gestational period is safe and feasible to mother and fetus,is a operation that has the least invasiveness.To hold a suitable occasion of operation,and experienced gynecology endoscope doctor is a important factor to the safety of mother and fetus.