腹腔镜手术治疗休克型异位妊娠的临床分析

Clinical analysis of laparoscopic surgery for ectopic pregnancy with shock

目的探讨腹腔镜手术治疗休克型异位妊娠的临床疗效。方法回顾性分析2005年1月-2012年6月解放军总医院收治的48例异位妊娠失血性休克患者的临床资料,其中腹腔镜手术25例、开腹手术23例,对比两组术前、术中与术后的相关情况。结果腹腔镜组和开腹组术前腹腔积血分别为2465.2±712.6ml和2716.7±954.9ml,腹腔镜组和开腹组术后HCG恢复时间为6.8±2.3d和7.2±2.8d,两组相比差异无统计学意义;腹腔镜组手术时间、术后排气及住院时间(分别为53.1±36.3min、1.2±0.4d、2.8±1.4d)明显短于开腹组(分别为127.0±21.4min、2.3±0.6d、4.6±2.2d),差异均有统计学意义(P<0.05)。结论腹腔镜手术治疗休克型异位妊娠创伤小、手术时间短、术后恢复快,是一种值得推广的术式。

Objective To investigate the efficacy of laparoscopic surgery for ectopic pregnancy with hemorrhagic shock. Methods The clinical data of 48 patients with hemorrhagic shock as a result of ectopic pregnancy, admitted to General Hospital of PLA from Jan. 2005 to June 2012, were analyzed retrospectively. Among them, 25 underwent laparoscopic surgery and 23 received traditional laparotomy. The preoperative, intra-operative and post-operative conditions were compared between the two groups. Results The intraperitoneal hemorrhage and HCG recovery time were 2465.2 ±712.6ml and 6.8± 2.3d respectively in laparoscopic group, and 2716.7± 954.9ml and 7.2 ± 2.8d respectively in laparotomy group, and there was no significant difference between two groups. The operation time, postoperative exsufflation time and length of hospital stay were 53.1 ± 36.3min, 1.2 ± 0.4d and 2.8 ± 1.4d respectively in laparoscopic surgery group, and 127.0 ±21.4min, 2.3 ± 0.6d and 4.6 ± 2.2d respectively in laparotomy group, and the difference between two groups was significant （P〈0.05）. Conclusion Laparoscopic surgery is worthy of popularization for ectopic pregnancy complicated by shock due to its minimal invasion, short operation time and earlier postoperative recovery.