腹腔镜和开腹手术治疗异位妊娠临床对比研究.docVIP

腹腔镜和开腹手术治疗异位妊娠临床对比研究 　　【摘要】 目的 探讨腹腔镜手术治疗异位妊娠的临床疗效并与开腹手术对比。方法 2007年3月至2008年10月,在本院采用腹腔镜手术治疗的异位妊娠患者共32例,观察手术时间、术后镇痛例数、术后发热例数、肠蠕动恢复时间、住院时间。同期行开腹手术治疗的患者共47例作为对照。结果 除手术时间无显著性差异外,术后镇痛例数,术后发热例数,肠蠕动恢复时间,住院时间经统计学处理,差异均有统计学意义。结论 与开腹手术相比,腹腔镜手术疗效确切,并且对患者创伤小,恢复快,并发症少,是治疗异位妊娠的首选方法。 　　【关键词】 腹腔镜;开腹手术;异位妊娠 　　 　　Clinical comparative between laparoscopic and laparotomy for treatment of ectopic pregnancy 　　LIAO Wei,GENG Ai-zhi,LI Yan-xia,et al. 　　Department of Gynecology,The 2nd People’s Hospital of Liaocheng,Affiliated Hospital of Tai shan Medical College,Linqing 252600,Shan dong,China 　　【Abstract】 Objective To study the clinical result of laparoscopic for treatment of ectopic pregnancy and compared with laparotomy. Methods From 2007-3 to 2008-10,32 cases of ectopic pregnancy were treated with laparoscopic in our hospital and operative time,blood loss during surgery,postoperative pain,hospitalization time,recovery time of bowel movement and the rate of postoperative fever were observed. 47 cases were treated with laparotomy as controls in the same period. Results In addition to operative time,there were statistical significant of postoperative pain,hospitalization time,recovery time of bowel movement and the rate of postoperative fever. Conclusion Compared with laparotomy,laparoscopic surgery is accurate,less traumatic for patients,rapid recovery and less complications. It is the preferred method for treatment of ectopic pregnancy. 　　【Key words】 Laparoscopy; Laparotomy; Ectopic pregnancy 　　 　　异位妊娠是指受精卵种植在子宫体腔以外部分的妊娠,近年来因人工流产,药物流产的增加及相应的盆腔炎性反应的增加,导致其发病率逐年升高,是妇科常见的急症手术病种。腹腔镜的不断发展和普及,为手术治疗异位妊娠提供了新的方法。2007年3月至2008年10月,在本院采用腹腔镜手术治疗异位妊娠的患者共32例,并与同期行开腹手术治疗的47例患者对比观察临床疗效,现报告如下。 　　1 资料与方法 　　1.1 一般资料 2007年3月至2008年10月因异位妊娠手术治疗患者79例。其中腹腔镜手术治疗异位妊娠患者32例,年龄19~46岁,平均(30.8±6.3)岁。其中经产妇25例,既往有腹部手术史12例(剖宫产6例,卵巢肿瘤剥除3例,输卵管结扎1例,输卵管吻合2例),有停经史28例,既往有盆腔炎病史4例,低血容量休克患者8例,阴道后穹隆穿刺抽出不凝血者30例。行开腹手术治疗异位妊娠患者47例,年龄20~48岁,平均(29.8±6.3)岁。其中经产妇32例,既往有腹部手术史17人(剖宫产8例,卵巢肿瘤剥除4例,输卵管结扎1,输卵管吻合2例,阑尾切除2例),有停经史38例,既往有盆腔炎