摘要
目的:探讨腹腔镜手术治疗异位妊娠的优越性。方法:229例异位妊娠患者随机分为两组。腹腔镜组131例采用气管插管+静脉全身麻醉,常规建立气腹,腹腔积血多时先用吸引器将大部分游离血吸出,暴露术野,根据病灶部位、是否破裂、有无生育要求等决定手术方式。开腹组98例,采用硬膜外麻醉,按常规开腹行输卵管切除术、输卵管开窗取胚术或卵巢胚胎切除术。结果:腹腔镜组1例宫角妊娠中转开腹,余均顺利完成手术。两组患者的术中出血量、手术时间、术后需镇痛例数、术后并发症发生例数、肛门排气时间及住院时间差异均有统计学意义(P<0.05)。结论:腹腔镜手术出血少、手术时间短、术后不需镇痛、术后病率低、肛门排气时间早、住院时间短、恢复快、并发症少、术后妊娠率高,可作为治疗异位妊娠的首选术式。
Objective：To investigate the advantage of laparoscopy for ectopic pregnancy. Methods：Two hundred and twentynine cases of ectopic pregnancy were divided into 2 groups randomly. There were 131 cases in laparoscopic group,with tracheal intubation and general anesthesia. Pneumoperitoneum was created routinely, laparoscope was inserted to observe abdominal cavity. If there was large amount of blood in peritoneum, they were extracted by suction apparatus and operative area was exposed. Operative method was decided by location of lesions, whether it had ruptured and whether patients wanted to preserve their fertility. There were 98 cases in laparotomy group, with epidural anesthesia. The open salpingectomy, salpingostomy or resection of ovarian embryo was completed routinely. Results：One case of cornual pregnancy in laparoscopic group converted to open surgery, the other operations completed successfully. The difference of bleeding during operation, time of surgery, analgesia needed after operation, postoperative complications, recovery of intestinal function and hospitalization between 2 groups were significant （P〈0.05）. Conclusions： Compared with laparotomy group, laparoscopic group owns a lot of advantages, such as less bleeding during operation, shorter time of surgery, no analgesia needed after operation, earlier recovery of intestinal function, shorter hospitalization, quicker recovery,less complications and higher pregnancy rate. Laparoscopy is the first choice for the surgery of ectopic pregnancy.
出处
《腹腔镜外科杂志》
2009年第4期268-270,共3页
Journal of Laparoscopic Surgery
关键词
腹腔镜术
妊娠
异位
Laparoscopy
Pregnancy, ectopic
