基层医院多孔腹腔镜手术治疗输卵管妊娠的疗效及安全性

Efficacy and safety of porous laparoscopic surgery in the treatment of tubal pregnancy.

目的研究基层医院多孔腹腔镜手术治疗输卵管妊娠的疗效及安全性。方法选取儋州市那大镇卫生院妇产科2019年12月至2021年11月期间收治的100例输卵管妊娠患者作为研究对象。按随机数表法分为观察组和对照组各50例。对照组患者采用传统的开腹手术治疗,观察组患者采用多孔腹腔镜手术治疗。在术中与术后记录并比较两组患者的手术时间、术中出血量、术后排气时间、住院时间、下床时间、住院费用、术后视觉模拟(VAS)评分、术后血绒毛膜促性腺激素(血β-HCG)恢复正常时间及术后并发症发生率与术后满意度。结果观察组患者的手术时间、术中出血量、术后排气时间、住院时间、下床时间、住院费用分别为(45.62±6.34)min、(68.32±6.24)mL、(12.35±2.61)h、(5.23±1.04)d、(9.63±2.04)h、(3624.62±254.31)元,明显短/少/低于对照组的(72.18±5.82)min、(98.24±5.92)mL、(29.52±3.64)h、(9.85±2.06)d、(15.26±3.16)h、(6242.57±236.76)元,差异均有统计学意义(P<0.05);观察组患者术后VAS评分、术后血β-HCG恢复正常时间分别为(3.56±0.24)分、(13.26±2.94)d,明显低/短于对照组的(6.23±0.18)分、(21.34±3.62)d,差异均有统计学意义(P<0.05);观察组患者术后并发症发生率为2.00%,明显低于对照组的14.00%,而患者术后满意度为96.00%,明显高于对照组的78.00%,差异均有统计学意义(P<0.05)。结论采用多孔腹腔镜手术治疗输卵管妊娠,不仅有助于缩短手术时间与住院时间,且术后创伤小、疼痛轻、费用低、安全性高、具有基层医院临床推广应用价值。

Objective To study the efficacy and safety of porous laparoscopic surgery in the treatment of tubal pregnancy.Methods One hundred patients with tubal pregnancy admitted in Department of Obstetrics and Gynecology,Nada Township Health Center from December 2019 to November 2021 were selected as the research objects.They were randomly divided into a study group and a control group,with 50 cases in each group.The control group was treated with traditional open surgery,and the study group was treated with porous laparoscopic surgery.The operation time,intraoperative bleeding,postoperative exhaust time,length of hospital stay,time of getting out of bed,hospitalization expenses,postoperative VAS score,and bloodβ-HCG return to normal time,the incidence of postoperative complications,and postoperative satisfaction were compared between the two groups.Results The operation time,intraoperative blood loss,postoperative exhaust time,length of hospital stay,time of getting out of bed,and hospitalization expenses of the study group were(45.62±6.34)min,(68.32±6.24)mL,(12.35±2.61)h,(5.23±1.04)days,(9.63±2.04)h,and(3624.62±254.31)yuan,which were significantly shorter/less/lower than(72.18±5.82)min,(98.24±5.92)mL,(29.52±3.64)h,(9.85±2.06)days,(15.26±3.16)h,(6242.57±236.76)yuan in the control group(P<0.05).Postoperative VAS score and bloodβ-HCG return to normal time in the study group was(3.56±0.24)points and(13.26±2.94)days,which were significantly lower/shorter than(6.23±0.18)points and(21.34±3.62)days in the control group(P<0.05).The incidence of postoperative complications in the study group was 2.00%,significantly lower than 14.00%in the control group(P<0.05).The postoperative satisfaction of patients in the study group was 96.00%,which was significantly higher than 78.00%in the control group(P<0.05).Conclusion Porous laparoscopy is effective in the treatment of tubal pregnancy.It helps to shorten the operation time and length of hospital stay,and has the advantages of small trauma,light pain,low cost,high safety and high satisfaction,which has great clinical application value and is worthy of popularization.