摘要
目的评判腹腔镜手术治疗输卵管妊娠腹腔内大出血患者的效果与安全性。方法因输卵管妊娠致腹腔内出血(>600mL)且需要剖腹探查的患者121例,其中腹腔镜下探查手术54例(腹腔镜组)、常规开腹探查手术67例(开腹手术组),对其临床资料作回顾性分析。结果腹腔镜组与开腹组的麻醉时间分别为(109.69±33.65)h及(103.73±35.42)h,手术时间为(78.85±32.64)h及(82.82±34.86)h,两者无统计学差异(P>0.05);肛门排气时间分别为(21.72±6.54)h及(31.75±7.81)h,术后平均住院天数(5.39±0.71)d及(8.30±2.54)d,两组比较均有统计学差异(P<0.05)。腹腔镜组术后镇痛比率为9.3%(5/54),术后发热率16.7%(9/54),明显低于开腹手术组的23.9%(16/67)和35.8%(24/67)(P<0.05)。腹腔镜组无切口愈合不良发生,开腹组有6例切口愈合不良(9.0%),两组患者术前和术后血压、心率无明显差异(P>0.05)。腹腔镜手术组气腹后收缩压对比无明显差异(P>0.05),气腹后舒张压高于开腹组,心率低于常规手术组(P<0.05)。结论腹腔镜下对输卵管妊娠导致腹腔大出血的探查手术安全有效,创伤少,恢复快,并发症较少。在满意的麻醉和心电监护下,对输卵管妊娠腹腔大出血的患者可选择实施腹腔镜手术。
Objective To evaluate the efficacy and security of laparoscopic surgery for tubal pregnancy patients with abdominal bleeding. Methods To collect 121 cases who was tubal pregnancy with abdominal bleeding on laparotomy from May 2003 to August 2006. It could divide into the exploration of laparoscopic surgery （laparoscopic group 54 cases） and conventional open exploratory surgery （ Laparotomy group 67 cases）. The two groups of clinical data were analyzed retrespectively. Results Laparoscopic group and laparotomy group of narcotic time was respectively （ 109.69 ± 33.65 ） h and （ 103.73 ± 35.42 ） h, the operation time is respectively （ 78.85 ± 32.64 ） h and （ 82.82 ± 34.86 ） h. It was no significant difference （ P 〉 0.05 ）. The anal exhaust time was respectively （21.72 ± 6.54） h and （ 31.75 ± 7.81 ） h, and the pest-operative an average hospital stay was respectively （5.39 ±0.71 ） d and （8.30 ±2.54） d. These two groups had significant difference （ P 〈 0.05 ）. Laparoscopic group post-operative analgesia rate 9.3% （ 5/54 ）, postoperative fever rate 16.7% （9/54） were significantly lower than the laparotomy group 23.9% （ 16/67 ） and 35.8% （24/67） （ P 〈 0.05 ）. There was no laparoscopic incisions heal bad happened,the group is open six cases wound healing bad （9.0%） ,two groups of patients before and after blood pressure, heart rate no significant difference （ P 〉 0. 05 ）. Laparoscopic surgery group after systolic pneumoperitoneum contrast there was no significant differenee（ P 〉 0. 05 ）, diastolic blood pressure than pneumoperitoneum after laparotomy group, heart rate lower than the conventional surgery group （P 〈 0. 05 ）. Conclusion Laparoseopie tubal pregnancy led to the exploratory surgery abdominal bleeding safe and effective,less traumatic, rapid recovery and fewer complications. In the perfect anesthesia and eardiorespiratory monitor, tubal pregnancy patients with abdominal bleeding could choose to implement the la
出处
《微创医学》
2008年第5期425-427,共3页
Journal of Minimally Invasive Medicine
关键词
腹腔镜手术
开腹手术
输卵管妊娠
腹腔内出血
Laparoscopic surgery
Laparotomy
Tubal pregnancy
Abdominal hemorrhage
