经脐单孔腹腔镜在输卵管妊娠中的应用价值

Application value of transumbilical single-port laparoscopic surgery for tubal pregnancy

目的探讨经脐单孔腹腔镜应用在输卵管妊娠中的安全性及临床价值。方法回顾性分析90例行腹腔镜手术治疗的输卵管妊娠患者临床资料,根据手术方式将患者分为经脐单孔腹腔镜组(单孔组,42例)和传统腹腔镜组(传统组,48例)。比较2组患者手术时间、术中出血量、术后肛门排气时间、住院时间、β-HCG水平恢复时间;比较2组患者术后并发症发生情况、VAS评分、输卵管通畅情况;术后随访1年,比较2组患者术后排卵情况及妊娠情况。结果单孔组手术时间长于传统组,而β-HCG水平恢复时间和住院时间均短于传统组,差异均有统计学意义(P<0.05);2组术中出血量和术后肛门排气时间比较,差异均无统计学意义(P>0.05)。单孔组术后并发症发生率低于传统组,差异有统计学意义(P<0.05)。单孔组术后1 d和术后3 d的VAS评分均低于传统组,差异有统计学意义(P<0.05)。单孔组术后输卵管通畅率与传统组比较,差异无统计学意义(P>0.05)。单孔组与传统组术后排卵率、再次异位妊娠率与再次宫内妊娠率比较,差异无统计学意义(P>0.05)。结论经脐单孔腹腔镜手术治疗输卵管妊娠疗效确切,且术后并发症少,患者疼痛感轻,术后恢复快。

Objective To investigate the safety and clinical value of transumbilical single-port laparoscopic surgery for tubal pregnancy.Methods The clinical data of 90 cases of tubal pregnancy patients treated by laparoscopic surgery in our hospital were retrospectively analyzed.The patients were divided into the transumbilical single-port laparoscopy group(single-port group,42 cases)and the traditional laparoscopy group(traditional group,48 cases)according to the surgical methods.The operation time,intraoperative blood loss,postoperative anal exhaust time,hospitalization time,and recovery time ofβ-HCG level in the two groups were compared.The incidence of postoperative complications,VAS score and fallopian tube patency were compared between the two groups.The postoperative ovulation and pregnancy were compared between the two groups during the one-year follow-up after surgery.Results The operation time in the single-port group was significantly longer than that of the traditional group,while the recovery time ofβ-HCG level and hospitalization time in the single-port group were significantly shorter than those of the traditional group,and the differences were statistically significant(P<0.05).There was no significant difference in the amount of intraoperative blood loss and postoperative anal exhaust time between the two groups(P>0.05).The incidence of postoperative complications in the single-port group was lower than that in the traditional group,and the difference was statistically significant(P<0.05).The VAS scores of the single-port group at 1 day and 3 days after surgery were lower than those of the traditional group,and the difference was statistically significant(P<0.05).There was no significant difference in postoperative fallopian tube patency rate between the two groups(P>0.05).There was no significant difference between the single-port group and the traditional group in postoperative ovulation rate,re-ectopic pregnancy rate and intra-uterine pregnancy rate(P>0.05).Conclusion Transumbilical single-port laparoscopic surgery for tubal pregnancy has definite curative effect,less postoperative complications,light pain and quick postoperative recovery.