腹腔镜手术治疗异位妊娠出血性休克孕妇临床研究及感染预防

Clinical study and infection prevention for laparoscopic surgery in treatment of hemorrhagic shock in ectopic pregnant women

目的探讨腹腔镜手术治疗异位妊娠出血性休克孕妇的临床效果,制定围术期感染预防措施,以降低感染率。方法选择妇产科2010年4月-2013年6月收治的异位妊娠伴出血孕妇124例,随机分为试验组和对照组各62例,对照组采用开腹术,试验组采用腹腔镜手术,比较两组相关指标,采用SPSS 13.0软件进行统计分析。结果试验组孕妇术后胃肠功能恢复时间、术后下床活动时间、住院天数、术后镇痛例数均明显低于对照组,差异有统计学意义(P<0.05);两组孕妇皮肤切开愈合情况良好,均为甲级愈合,试验组孕妇术后无感染出现,对照组有2例孕妇发生医院感染,两组医院感染率相比差异有统计学意义(P<0.05)。结论抗休克治疗的同时进行腹腔镜手术,术中要求手术者技术熟练,同时做好严密的监测及围术期感染预防工作,降低感染率,提高治疗水平。

OBJECTIVE To investigate the clinical effects of laparoscopic surgery for hemorrhagic shock in ectopic pregnancy,and to explore prevention measures of perioperative infections to reduce infection rates.METHODS Totally 124 cases of ectopic pregnant women with bleeding in the obstetric department during Apr.2010 to Jun.2013 were enrolled and randomly divided into the experimental group and the control group with 62 patients in each group.The control group received open surgery,while the experimental group received laparoscopic surgery.Related indexes were compared between the two groups and the software SPSS13.0was used for statistical analysis.RESULTS The recovery duration of gastrointestinal function after surgery,postoperative ambulation time,length of stay,the number of cases of postoperative analgesia were significantly lower in the experimental group than in the control group（P〈0.05）.Both groups of patients had skin incision healed well which were Grade I healing.Postoperative hospital infections occurred in none cases in the experimental group and in 2cases in the control group,the difference in the hospital infection rate between the two groups was significant（P〈0.05）.CONCLUSIONLaparoscopic surgery which was performed with the anti-shock treatment requires skilled operation as well as rigorous monitoring and perioperative infection prevention so as to reduce infection rates and improve treatment level.