腹腔镜与开腹手术治疗输卵管妊娠致腹腔内大出血的效果比较.docVIP

腹腔镜与开腹手术治疗输卵管妊娠致腹腔内大出血的效果比较 　　[摘要] 目的 比较腹腔镜与开腹手术治疗输卵管妊娠致腹腔内大出血的效果。 方法 回顾性分析2000年1月～2015年10月104例在普宁市妇幼保健院妇科住院、因输卵管妊娠致腹腔内大出血行手术治疗的患者的临床资料，其中66例行腹腔镜手术，38例行开腹手术，比较两组患者的治疗效果。 结果 腹腔镜组患者中原有3例因盆腔严重粘连、出血凶猛而中转开腹，其余均在腹腔镜下顺利完成，成功率为95.7%；两组均取得很好的临床疗效，无一例术中、术后并发症发生；与开腹组患者比较，腹腔镜组患者盆腹腔积血量明显较少，且手术时间明显较短（P均0.05）；腹腔镜组患者术后肛门排气时间、术后首次下床时间均短于开腹组（P均0.05）。 结论 与开腹手术比较，腹腔镜手术对腹腔内大出血的输卵管妊娠患者具有快速止血、手术时间短等优势，值得临床推广 [关键词] 输卵管妊娠；腹腔出血；腹腔镜手术；开腹手术 [中图分类号] R714.22 [文献标识码] A [文章编号] 1674-4721（2016）03（b）-0081-03 [Abstract] Objective To compare the effect of laparoscopy and laparotomy in the treatment of fallopian pregnancy induced intra-abdominal bleeding. Methods Clinical data of 104 patients who were hospitalized in Maternal and Child Health Care Hospital of Puning City and were given surgical treatment due to fallopian pregnancy induced intra-abdominal bleeding from January 2000 to October 2015 were retrospectively analyzed.66 patients were given laparoscopy and 38 patients were given laparotomy.Curative effects were compared between the two groups. Results 3 patients in the laparoscopy group were changed to laparotomy due to severe adhesion of pelvic cavity and unstoppable bleeding，and others were successfully completed under laparoscopy，with the successful rate of 95.7%；The clinical curative effects were favorable in the two groups，without complications during the surgery and after the surgery；Compared with the patients in the laparotomy group，the volume of bleeding in the pelvic cavity in the patients in the laparoscopy group was significantly lower，and the surgery time was significantly shorter（all P 　　1 资料与方法 1.1 一般资料 2000年1月～2015年10月在普宁市妇幼保健院妇科住院治疗的输卵管妊娠患者共1125例，其中578例患者接受手术治疗。选取行腹腔镜或开腹手术治疗、临床资料完整且符合以下标准的患者为研究对象：①术前患者生命体征和血红蛋白检测提示有血流动力学不稳定；②行患侧输卵管切除术；③经手术及病理检查证实为输卵管妊娠；④术中测量盆腹腔积血量≥800 ml。共有104例患者符合入选标准，按手术方式将患者分为腹腔镜组（66例）和开腹组（38例）。两组患者在年龄[（26.2±3.7）岁 vs （28.5±4.3）岁]、孕次[（2.7±1.6）次 vs （2.5±1.7）次]、产次[（1.8±1.4）次 vs （1.6±1.4）次]、BMI[（24.3±5.8） kg/m2 vs （24.8±5.5）kg/m2]、妊娠周数[（6.9±1.6）周 vs