腹腔镜低气腹压法治疗宫外孕大出血的临床观察

目的研究腹腔镜低气腹压法在宫外孕大出血应用的可行性和临床效果。方法对262例因宫外孕大出血需腹腔镜手术探查的患者吸出盆腔积血探查处理宫外孕病灶后随机分为两组,观察组气腹压力降至8mmHg,对照组腹腔压力在14mmHg,清除腹腔肠管间积血。观察清除腹腔积血的手术时间、吸出血量、术后腹痛消失时间、肠功能恢复时间、术后住院时间。结果观察组清除腹腔积血时间、术后腹痛消失时间、肛门排气时间及平均住院时间要小于对照组,两组比较差异有统计学意义(P<0.05);观察组清除腹腔积血量高于对照组,差异有统计学意义(P<0.05)。结论腹腔镜低气腹压法治疗宫外孕大出血,在清除腹腔积血过程中可缩短手术时间,增加清除的腹腔积血量,促进患者恢复,是治疗宫外孕大出血的一种有效方法。

Objective To study the feasibility and clinical application of laparoscopic treatment of ectopic pregnancy bleeding with lowpressure pneumoperitoneum. Methods 262 patients underwent laparoscopic operation with ectopic pregnancy bleeding were included in this study. After aspiration of pelvic hematocele and treatment of ectopic pregnancy lesions, all the patients were randomly divided into two groups： the observation group and the control group. The pneumoperitoneum pressure of observation group is 8 mmHg, and that of control group was 14 mmHg. Surgery time of clearing hemoperitoneum, the absorption amount of bleeding, abdominal pain disappeared after time, intestinal function recovery time, postoperative hospital stay were observed. Results Compared with the control group, the time spended to removal of hemoperitoneum, postoperative abdominal pain disappeared time, anal exhaust time, and the average hospitalization time in observation group were much shorter, there was significant difference between two groups （P〈0.05）. Total amount of celiac hematocele removed from abdominal cavity in observation group was higher than thant in control group, there was significant difference between two groups （P〈0.05）. Conclusion Laparoscopic treatment of ectopic pregnancy bleeding with low-pressure pneumoperitoneum can shorten the operation time and the total amount of celiac hematocele removed from abdominal cavity is much higher, which can reduce the incidence of postoperative complications and is beneficial to the recovery of patients.