腹腔镜手术与开腹手术治疗异位妊娠的临床研究

Clinical Study on Laparoscopic Operation Vs.Open Operation in the Treatment of Ectopic Pregnancy

目的比较腹腔镜手术与开腹手术治疗异位妊娠的临床效果,寻找最佳手术治疗方式。方法选择符合标准的患者80例,随机分为观察组和对照组各40例,观察组采用腹腔镜手术,对照组采用传统开腹手术,比较手术效果。结果观察组患者手术时间(50.24±10.72)min,术中出血量(67.93±14.95)m L;对照组患者手术时间(82.39±15.80)min,术中出血量(99.14±20.83)m L;观察组患者手术时间及术中出血量均低于对照组,差异有统计学意义(P<0.05)。观察组患者术后肛门排气时间、术后下床活动时间及术后住院时间均短于对照组,差异有统计学意义(P<0.05)。观察组有生育要求保留输卵管者28例、对照组26例,术后输卵管通畅率及宫内妊娠率均高于对照组,差异有统计学意义(P<0.05)。结论腹腔镜下手术治疗异位妊娠,具有手术创伤小、术后恢复快、术后宫内妊娠率高、异位妊娠复发率低,尤其适合有保留生育要的异位妊娠患者。

Objective To compare the clinical effect of laparoscopic operation vs. open operation in the treatment of ectopic preg-nancy so as to search for the best operation way. Methods 80 eligible patients were selected and randomly divided into observation group and control group, with 40 patients in each group. The observation group used laparoscopic operation, while the control group used traditional open operation, and the effects were compared. Results The operative time and intra-operative blood loss in the patients of the observation group was （50.24±10.72） min and （67.93±14.95） ml, respectively, while that in the patients of the control group was （82.39±15.80） min and （99.14±20.83） ml, respectively. The operative time and intra-operative blood loss in the patients of the observation group were both less than those of the control group, and the differences were statistically significant （P〈0.05）. The patients of the observation group had shorter postoperative time for passage of gas by anus and out-of-bed activity, and postoperative length of stay than those of the control group, and the differences were statistically significant （ P〈0.05）. Twenty-eight patients of the observation group and twenty-six patients of the control group required to keep fallopian tubes, but the post-operative patency rate of fallopian tubes and intrauterine gestation rate in the patients of the observation group were both higher than those of the control group, and the differences were statistically significant （P〈0.05）. Conclusion Laparoscopic operation for the treatment of ectopic pregnancy has advantages of smaller operation wound, rapider postoperative recovery, higher rate of post-operative intrauterine gestation, and lower recurrence rate of ectopic pregnancy, and is especially applicable for the ectopic preg-nancy patients requiring preservation of fertility.