腹腔镜与开腹手术治疗异位妊娠的临床疗效比较

Comparison of Clinical Effects between Laparoscopic and Open Surgery for Ectopic Pregnancy

目的对比分析异位妊娠患者采用腹腔镜手术以及开腹手术治疗的临床疗效。方法选取2015年1月—2017年2月于该院妇产科行手术治疗的100例异位妊娠患者,按照随机抽签法分为实验组(50例,腹腔镜手术终止妊娠)和对照组(50例,开腹手术终止妊娠),对比两组患者相关手术指标、住院时间以及12个月内妊娠情况。结果两组肛门排气时间差异无统计学意义(P>0.05),实验组患者出血量(50.3±8.8)mL、手术时间(49.8±11.1)min、伤口大小(4.1±0.8)cm、住院时间(6.2±1.4)d指标均优于对照组(t=19.598、12.902、33.602、7.702,P<0.05)。对患者进行12个月随访,实验组患者宫内妊娠率88%明显高于对照组56%(χ~2=4.621,P<0.05),实验组患者异位妊娠率12%明显低于对照组44%(χ~2=8.494,P<0.05)。结论排除禁忌证的情况下,异位妊娠患者采用腹腔镜手术的效果更优于开腹手术,具有切口小、手术时间短、术后恢复快等诸多优点,值得在临床上广泛推广应用。

Objective To compare the clinical efficacy of laparoscopic surgery and open surgery in patients with ectopic pregnancy. Methods 100 patients with ectopic pregnancy who underwent surgical treatment in the department from January 2015 to February 2017 were enrolled in the experimental group （50 cases, laparoscopic termination of pregnancy） and the control group （50 cases were treated with laparotomy to terminate the pregnancy）. The surgical parameters, hospitalization time and pregnancy within 12 months were compared between the two groups. Results There was no statistically significant difference in the anal exhaust time between the two groups （P〉0.05）. The bleeding volume of the experimental group was （50.3±8.8）mL, the operation time was （49.8±11.1） min, and the wound size was （4.1±0.8） cm. The hospitalization time （6.2±1.4） d index was better than the control group （t=19.598, 12.902, 33.602, 7.702, P〈0.05）. The patients were followed up for 12 months. The intrauterine pregnancy rate of the experimental group was 88% higher than that of the control group 56% （χ2=4.621, P〈0.05）. The ectopic pregnancy rate of the experimental group was 12% significantly lower than the control group 44%（χ2=8.494, P〈0.05）. Conclusion In the case of contraindications, the effect of laparoscopic surgery in patients with ectopic pregnancy is better than that of open surgery. It has many advantages such as small incision, short operation time and quick recovery. It is worthy of widespread application in clinical practice.