分析输卵管妊娠的腹腔镜与开腹手术保留输卵管临床疗效

To Analyze the Clinical Effect of Laparoscopic and Laparotomy for Tubal Pregnancy

目的分析输卵管妊娠的腹腔镜与开腹手术保留输卵管临床疗效。方法选择我院于2016年6月至2019年6月收治的90例输卵管妊娠患者,按照治疗方式不同分为对照组(45例,使用开腹手术进行保留输卵管手术)与观察组(45例,使用腹腔镜进行保留输卵管手术),对比两组患者手术前后的出血量、手术进行时间、首次进行肛门排气时间、首次下床活动时间、住院天数、和患者术后输卵管通畅率,并对比两组患者抗生素使用时间、镇痛剂使用量、住院费用术后随访情况。结果观察两组患者经过腹腔镜与开腹手术后的输卵管通畅率,观察组术后输卵管通畅率为91.11%;对照组术后输卵管通畅率为60.00%。使用腹腔镜进行治疗的观察组患者的输卵管通畅率明显高于使用开腹手术的对照组(P<0.05)。两组患者接受治疗后均有一定程度好转,但对比两组患者手术前后出血量、手术时间,观察组明显少于对照组(P<0.05);观察组患者首次进行肛门排气时间、首次下床活动时间和住院天数明显早于对照组(P<0.05);两组患者接受治疗后,观察组患者抗生素使用时间、镇痛剂使用量、住院费用均优于对照组(P<0.05)。两组患者接受治疗后,观察组患者在血β-HCG降至正常所需时间、月经恢复至正常时间、1.5年内同侧重复异位妊娠方面与对照组比较,差异无统计学意义(P>0.05)。在恢复日常工作时间、术后3个月输卵管通畅情况两方面,观察组显著优于对照组(P<0.05)。结论腹腔镜与开腹手术都能有效治疗输卵管妊娠,但腹腔镜能明显提高输卵管通畅率,有利于术后女性的生育计划,具有推广应用价值。

Objective To analyze the clinical efficacy of tubal preservation in laparoscopic and open surgery for tubal pregnancy.Methods The 90 patients with tubal pregnancy admitted to our hospital from June 2016 to June 2019 were selected and divided into a control group(45 cases,using laparotomy for tubal preservation surgery)and an observation group(45 cases)according to different treatment methods,Using laparoscopy for fallopian tube preservation surgery),compare the blood loss before and after the operation,the operation time,the first anal exhaust time,the first time to get out of bed,the number of days in hospital,and the postoperative fallopian tube patency rate of the two groups of patients,and compare them The duration of antibiotic use,the amount of analgesics,and hospitalization expenses in the two groups were followed up after surgery.Results Observe the patency rate of the fallopian tube after laparoscopic and open surgery in the two groups.The patency rate of the fallopian tube after treatment in the observation group was 91.11%;the patency rate of the fallopian tube in the control group was 60.00%.The patency rate of the fallopian tubes of the observation group who used laparoscopy was significantly higher than that of the control group who used open surgery(P<0.05).The two groups of patients improved to a certain extent after receiving treatment,but compared the two groups of patients before and after surgery,the amount of blood loss,the operation time,the observation group was significantly less than the control group(P<0.05);the time to exhaust,the time to get out of bed for the first hospitalization time were significantly earlier than those of the control group(P<0.05);after the two groups of patients received treatment,the time of antibiotic use,the amount of analgesics,and the cost of hospitalization in the observation group were better than those in the control group(P<0.05).After two groups of patients received treatment.After treatment,there were no significant differences between the observation group and the control group in the time required for bloodβ-HCG to return to normal,the time for menstruation to return to normal,and the ipsilateral repeated ectopic pregnancy within 1.5 years(P>0.05).In terms of return to daily work time and patency of the fallopian tube 3 months after surgery the observation group was significantly better than the control group(P<0.05).Conclusion Laparoscopy and open surgery can effectively treat tubal pregnancy,but laparoscopy can significantly improve tubal patency,which is beneficial to surgery Post-female birth planning has the value of promotion and application.