腹腔镜与开腹手术治疗宫外孕疗效及对术后受孕率影响

The clinical effect of laparoscopic surgery and traditional open surgery in treatment of ectopic pregnancy and their influence on post-opereative intrauterine pregnancy rate

目的比较宫外孕腹腔镜保守手术与传统开腹保守手术后宫内妊娠率。方法随访因宫外孕行腹腔镜保守手术及开腹保守手术治疗,且术后有生育要求患者共100例。其中腹腔镜组48例,开腹手术组52例。随访时间6年。结果腹腔镜手术患者手术时间(31.66±3.58)分钟、术中出血量(51.84±4.20)ml、肛门排气时间(9.66±1.75)小时、下床活动时间(5.4±1.09)小时明显少于开腹手术组,差异有统计学差异(P<0.01)。行急诊腹腔镜治疗的患者手术时间(33.25±5.17)分钟、术中出血量(68.48±12.45)ml、肛门排气时间(5.8±1.119)小时、下床活动时间(3.12±0.89)小时明显少于开腹手术组,差异有统计学差异(P<0.01)。腹腔镜组术后宫内妊娠31例,开腹手术组术后宫内妊娠21例,差异有统计学差异(P<0.01)。急诊腹腔镜组术后宫内妊娠8例,急诊开腹手术组术后宫内妊娠9例,差异没有统计学差异(P>0.05)。结论腹腔镜手术后较传统手术后,有较高的宫内妊娠率,对于择期手术患者应选择腹腔镜手术。

Objective To compare the rate of intrauterine pregnancy after ectopic pregnancy treated with laparoscopic surgery or traditional open surgery. Methods 100 cases with fertility requirements after ectopic pregnancy treated with laparoscopic surgery or open surgery were fol-lowed up for 6 years, 48 cases were treated with laparoscopic, 52 cases with open surgery. Results The operative time （31.66 ± 3.58） min, blood loss （51.84 ± 4.20） ml, flatus time（9.66 ± 1.75） h, ambulation time （5.4 ± 1.09） h in laparoscopic surgery group were significantly less than that in open surgery group（P〈0.01）. The operative time（33.25 ± 5.17） min, blood loss （68.48 ± 12.45） ml, flatus （5.8 ± 1.119） h, ambulation （3.12 ± 0.89） h in patients underwent emergency treated with laparoscopic surgery were significantly less in the open surgery group （ P〈0.01）. 31 cases had intrauterine pregnancy in laparoscopic surgery group, 21 cases in the open surgery group, there were significantly difference （P〈0.01）. 8 cases had in-trauterine pregnancy in emergency laparoscopic group ,9 cases in the emergency open group, there was no statistically significant difference （P＆gt;0.05）. Conclusions The rate of intrauterine pregnancy after ectopic pregnancy treated with laparoscopic surgery was higher than that with traditional open surgery.