腹腔镜治疗宫外孕256例临床研究.docVIP

腹腔镜治疗宫外孕256例临床研究[摘要] 目的：报道本院在2007年采用腹腔镜治疗宫外孕所取得的临床效果。方法：回顾性分析本院2007年对256例宫外孕患者的腹腔镜手术治疗。根据实际情况，分别采用输卵管取胚术、输卵管完全性切除手术、输卵管部分切除术。结果：手术时间为20～160 min；腹腔出血量为0～700 ml；肛门排气时间为3～13 h；常规留置尿管时间平均为6.0 h；下床活动时间为8 h；平均住院天数为3 d。结论：腹腔镜治疗宫外孕具有损伤小、痛苦小、恢复快、可完全止血等优点。但技术要求高、视野范围小、操作范围窄、费用高是其不足。 [关键词] 腹腔镜；宫外孕；治疗 [中图分类号] R714.22 [文献标识码]A [文章编号]1673-7210（2008）07（a）-048-02 Clinical analysis of 256 cases ectopic pregnancy treated by laparoscopic operation CHEN Gui-ying,HE Xiu-kui (Department of Gynoecology and Obstetrics,the Maternal and Child Care Hospital,Guangdong Province,Guangzhou 510010,China) [Abstract] Objective: To report the actual clinical effect of laparoscopic operation in the treatment of ectopic pregnancy during 2007. Methods: Retrospectively analyzing the data of 256 cases ectopic pregnancy in recent one year. According to different condition, removing embryo from oviduct， selecting complete resection operation for oviduct and partial resection operation for oviduct respectively. Results: The operation time was from 20 to 160 minutes. The blood loss in operation was 0～700 ml. The anus exhaust time was 3～13 hours. The average time of normal detaining urethral catheterization was 6 hours. The average time of ground activity was 8 hours. The average time of hospitalization was 3 days. Conclusion: There are some advantages for laparoscopic operation in thetreatment of ectopic pregnancy, such as little injury, less pain, performing-rapid recovery and controlling blood wholly. On the other hand, it also has some disadvantages, such as a complex operation, limited view scope, small operation space and high cost. [Key words] Laparoscopy;Ectopic pregnancy;Operation 腹腔镜是一种经特定管道进入人体，以观察人体内部状况并同时具有治疗功能的内视镜。1937年Hope最早提出以腹腔镜诊断子宫外孕的报告，1944年Raoul Palmer创造出Trendelenburg卧姿，并制定腹腔镜的操作常规，但直到20世纪70年代随着器械的改进，这项技术才迅猛发展起来，同时也使妇产科的腹腔镜手术更加安全、可靠[1]。有资料表明[2-4]，在治疗宫外孕方面，腹腔镜手术相对于传统开腹手术，具有创伤小、疼痛小、恢复快、并发症少、住院时间短等优点。腹腔镜手术现已成为子宫外孕的常规治疗方法。我院于2007年间采用腹腔镜治疗256例宫外孕患者，取得良好效果，同时对该手术方法的认识也进一步加