腹腔镜保守性手术在休克型异位妊娠治疗中的效果及再妊娠结局分析(1)
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【摘要】 目的 探讨腹腔镜保守性手术在有生育要求的休克型异位妊娠治疗中的效果及再妊娠结局。方法 回顾性分析142例行保守性手术治疗的有生育要求的异位妊娠患者,其中通过腹腔镜手术78例,开腹手术64例,比较两组手术时间,出血情况,术后排气时间,腹痛消失时间,住院天数,并随访输卵管通畅及受孕情况。结果 腹腔镜组手术时间、排气时间、腹痛消失时间、住院天数均短于开腹组,差异具有统计学意义(P<0.05);两组术中出血、术后输卵管通畅情况之间差异无统计学意义(P>0.05),腹腔镜组患者再妊娠率明显高于开腹组,差异具有统计学意义(P<0.05)。结论 腹腔镜治疗休克型异位妊娠患者是安全及可行的,并且能够显著提高再妊娠率。对于有生育要求的休克型异位妊娠患者,腹腔镜保守性手术应为首选。
【关键词】腹腔镜;保守性手术;异位妊娠;妊娠结局
Analysis of effects and repregnancy outcomes of Laparoscopy Conservative operations on the patients with Hemorrhagic Shock due to Ectopic Pregnancy
【Abstract】 Objective To explore the effects and repregnant outcomes of laparoscopy conservative operation on the patients with hemorrhagic shock due to ectopic pregnancy who desired for fertility.Methods The clinical data resulting from 142 patients with ectopic pregnancy treated by conservative operation were retrospectively analyzed,including 78 cases of laparoscopy and 64 cases of laparotomy,compared the operation time,blood loss,time of anus exsufflation,extinction time of abdominal pain,hospital days after operations,and followed up the uterine tube recanalization and androlepsis.Results The operation time,time of anus exsufflation,extinction time of abdominal pain,and hospital days after operations of laparoscopy were shorter than those of laparotomy,the differences had statistical significance(P<0.05).The differences of blood loss and uterine tube recanalization between the two groups didn’t have statistical significance(P>0.05).The repreganancy rate of laparoscopy was obviously higher than that of laparotomy,the difference had statistical significance(P<0.05).Conclusion Laparoscopic procedure is safe and feasible in management of patients with hemorrhagic shock due to ectopic pregnancy,and can raise the repregnancy rate.For those patients,the laparoscopy conservative operation was the first choice.
【Key words】Laparoscopy;Conservative operation;Ectopic pregnancy;Pregnancy outcome
异位妊娠是妇科常见病,在妇科急腹症中居首位,且其发病有逐年上升趋势,由于异位妊娠多发生在年轻育龄妇女,随后的妊娠是处理时需要考虑的一个重要因素[1]。近年来随着腹腔镜的优越性及其技术的不断成熟,腹腔镜手术已成为异位妊娠的首选手术方式,但是对于血液动力学不稳定的休克型异位妊娠腹腔镜技术仍存在争议,并且对于休克型异位妊娠多采用输卵管切除术。本文对我院应用腹腔镜保守性手术治疗有生育要求的休克型异位妊娠78例与开腹手术的64例进行比较分析,并追踪其后输卵管通畅及受孕情况,报告如下 ......
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