异位妊娠行腹腔镜手术与开腹手术后对再次异位妊娠的影响观察

Influence of laparoscopic surgery and laparotomy in ectopic pregnancy on recurrent ectopic pregnancy

目的探讨异位妊娠行腹腔镜手术和开腹手术后对再次异位妊娠的影响。方法对2011年1月—2014年12月我院妇产科确诊异位妊娠并进行保守性手术治疗的94例患者进行回顾性分析,其中腹腔镜(观察组)和开腹手术(对照组)各47例。比较不同手术对患者再次异位妊娠的影响。结果对照组术中出血量、住院时间、肛门排气时间、下床活动时间、再次受孕时间、留置导管时间及手术时间均长于观察组,差异有统计学意义(P<0.05);观察组术后未孕及再次异位妊娠概率均明显低于对照组,宫内妊娠率提高,差异有统计学意义(P<0.05);观察组持续性异位妊娠、同侧异位妊娠及对侧异位妊娠等发生情况优于对照组,差异有统计学意义(P<0.05)。结论与开腹手术比较,腹腔镜手术可缩短异位妊娠患者手术时间及术后恢复时间,降低术中出血量,减少再次异位妊娠。

Objective To investigate the influence of laparoscopic surgery and laparotomy in ectopic pregnancy on recurrent ectopic pregnancy.Methods 94 confirmed ectopic pregnancy patients with conservative surgery in the department of gynaecology and obstetrics from January 2011 to December 2014 were retrospectively analyzed,including 47 cases of laparoscopic surgery（observation group） and 47 cases of laparotomy（control group）.The influence of different surgery on recurrent ectopic pregnancy were compared.Results The intraoperative bleeding volume,hospital stays,anal exhaust time,leaving bed time,re-conception time,catheter indwelling time and operation time in ocntrol group were higher than those in observation group（P〈0.05）;The incidence of postoperative non-pregnancy and recurrent ectopic pregnancy was significantly lower than that in control group,and the intrauterine pregnancy rate increased（P〈0.05）;The occurrence of persistent ectopic pregnancy,ipsilateral ectopic pregnancy and contralateral ectopic pregnancy in observation group was better than control group（P〈0.05）.Conclusion Compared with laparotomy,laparoscopic surgery in ectopic pregnancy patients could shorten operation time and postoperative recovery time,decrease the intraoperative bleeding volume,reduce the incidence of recurrent ectopic pregnancy.