腹腔镜治疗异位妊娠41例分析

The analysis of 41 cases with ectopic gestation treated by laparoscope.

目的 :比较腹腔镜手术与剖腹手术及MTX单次肌注治疗异位妊娠的疗效、住院时间及住院费用。方法 :回顾分析经临床确诊的异位妊娠 136例。其中行腹腔镜手术组 (A组 ) 4 1例、剖腹手术组 (B组 ) 71例、MTX单次肌注组 (C组 ) 2 4例。记录异位妊娠病史 ,阳性体征 ,手术时间 ,术中出血量 ,腹腔内出血 ,抗生素应用时间 ,术后发热率 ,住院时间及费用 ,术后恢复状况 ,术后复查。结果 :腹腔镜手术组住院天数明显少于剖腹手术组及MTX组、A组与B组比较 ,A组与C组比较 ,P均 <0 0 1。住院费用明显多于剖腹手术组及MTX组 ,A组与B组比较 ,A组与C组比较 ,P均 <0 0 1。结论 :腹腔镜手术治疗异位妊娠住院日短 ,术后恢复快 ,损伤小 ,术中出血少 ,术后发热率低 ,效果佳。仅手术费用相对较高。

Objective:To compare the curative effect\,the time and the cost of hospitalization of operative laparoscope versus laparotomy and methotrexate single dose intramuscular injection for treating ectopic gestation.Methods:136 cases with ectopic gestation were given clinical confirmed diagnosis and analyzed retrospectively,and there were 41 cases in operative laparoscope group(group A),71 cases in laparotomy group(group B),24 cases in methotrexate single dose intramuscular injection group(group c).To record the case history\,the positive signs\,the average operative time and intraoperative blood loss\,the intraperitoneal hemorrhage\,the time of using antibiotic\,the postoperative fever rate\,the time and the cost of hospitalization\,the postoperative recovery and the postoperative reexamination of the patients with ectopic gestation.Results:The time of hospitalization of operative laparoscope group is obviously shorter than that of laparotomy group and methotrexate single dose intramuscular injection group.Compare group A with group B,and compare group A with group C,P<0\^01.The cost of hospitalization of operative laparoscope group is obviously more than that of laparotomy group and methotrexate single dose intramuscular injection group.Compare group A with group B,and compare group A with group C,P<0\^01.Conclusions:Operative laparoscope group had many good effects in treating ectopic gestation such as shorter time of hospitalization\,faster postoperative recovery\,smaller injury\,less intraoperative blood loss\,lower postoperative fever rate\,better curative effect and so on.Only operative cost was expensive relatively.It might be used spreadly.