经脐单孔腹腔镜与传统腹腔镜手术治疗输卵管妊娠的对比研究

Comparative Study Between Transumbilical Laparoscopic Single-site Surgery and Three-port Traditional Laparoscopy in the Treatment of Ectopic Pregnancy

目的比较经脐单孔腹腔镜与传统三孔腹腔镜异位妊娠手术的临床效果。方法选择2012年1月-2013年12月在我院接受异位妊娠手术120例,患者根据自身经济情况选择手术方式,其中单孔腹腔镜组66例,传统三孔腹腔镜组54例,比较2组患者手术时间、术中出血量、肠道功能恢复时间、术后疼痛视觉模拟评分、术后住院时间、手术费用、术后切口愈合情况、术后患者满意度等。结果单孔腹腔镜组手术时间（30.6±6.3）min,明显长于传统三孔腹腔镜组（20.1±6.9）min（t=8.701,P=0.000）。单孔腹腔镜组和传统三孔腹腔镜组术中出血量、肠道功能恢复时间、术后住院时间、术后拔除尿管时间、手术费用和术后患者满意度差异均无统计学意义（P〉0.05）。单孔腹腔镜组术后第1、3天疼痛视觉模拟评分分别为（3.2±0.8）、（1.5±0.7）分,显著低于传统三孔腹腔镜组（3.9±0.8）、（2.3±0.6）分（t=-4.769,P=0.000;t=-6.636,P=0.000）。结论单孔腹腔镜手术治疗异位妊娠是安全可行的,且能减轻患者的术后疼痛,并能达到更好的美容效果。

Objective To compare clinical outcomes between laparoscopic single-site surgery and traditional three-port laparoscopy in the treatment of ectopic pregnancy. Methods From January 2012 to December 2013,120 patients with ectopic pregnancy were randomly divided into either single-site group（ n = 66） or three-port group（ n = 54） in this hospital. The outcomes of laparoscopic single-site and three-port surgery were evaluated. The operative time,blood loss,intestinal function recovery time,postoperative pain scores,postoperative hospital stay,surgical costs,wound healing,and postoperative patient satisfaction were compared between the two groups. Results In the single-site group,the operative time（ 30. 6 ± 6. 3） min was longer than that in the three-port group（ 20. 1 ± 6. 9） min,with statistically significant difference（ t = 8. 701,P = 0. 000）. No difference was found in intraoperative blood loss, intestinal function recovery time, postoperative hospital stay, surgical costs, wound healing, and postoperative patient satisfaction between the two groups（ P〉0. 05）. On the first and third postoperative day,the VAS were（ 3. 2 ±0. 8） and（ 1. 5 ± 0. 7） points in the single-site group,which were significantly lower than those in the three-port group（ 3. 9 ± 0. 8）and（ 2. 3 ± 0. 6） points,with statistically significant differences（ t =-4. 769,P = 0. 000; t =-6. 636,P = 0. 000）. Conclusion Laparoscopic single-site surgery is feasible and safe to treat ectopic pregnancy,bearing decreased pain and improved cosmetic outcomes.