文章摘要
杨玉梅.腹和腹腔镜下治疗异位妊娠的临床效果及再次妊娠结局[J].中国医药导刊,2018,20(7):389-392.
腹和腹腔镜下治疗异位妊娠的临床效果及再次妊娠结局
The Clinical Efficacy of Laparotomy and Laparoscopy in the Treatment of Ectopic Pregnancy and the Outcome of the Second Pregnancy
投稿时间:2018-07-16  修订日期:2018-08-06
DOI:
中文关键词: 异位妊娠  开腹手术  腹腔镜手术  再次妊娠
英文关键词: Ectopic pregnancy  Laparotomy  Laparoscopy  Second pregnancy
基金项目:
作者单位E-mail
杨玉梅 上海市浦东新区人民医院妇产科 201300 1548597723@qq.com 
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中文摘要:
      目的:探究腹腔镜手术治疗与开腹手术治疗异位妊娠的临床效果差异及再次妊娠结局。方法:选择我院妇产科2014年11月至2016年12月收治的93例异位妊娠患者作为研究对象,依据治疗方法分为开腹手术治疗(开腹组)45例,腹腔镜手术治疗(腹腔镜组)47例。对比两组患者手术时间、切口长度、术中出血量、排气时间、人绒毛膜促性腺激素(HCG)恢复时间、住院时间、术后受孕情况、疼痛及并发症发生率等指标。结果:腹腔镜组患者手术时间稍多于开腹组,但差异统计学意义(P>0.05);腹腔镜组患者切口长度、术中出血量、排气时间、HCG恢复时间、住院时间均低于开腹组,差异均有统计学意义(P<0.05);开腹组术后6、24、48 h VAS评分均高于腹腔镜组,差异均有统计学意义(P<0.05);腹腔镜组并发症发生率(2.13%)低于开腹组(13.33%),差异有统计学意义(P<0.05);两组术后输卵管通畅情况、宫内妊娠率对比,腹腔镜组稍高于开腹组,但差异均统计学意义(P>0.05);两组1年内再次异位妊娠发生率对比,腹腔镜组低于开腹组,差异有统计学意义(P<0.05),未孕率比较,两组差异统计学意义(P>0.05)。结论:异位妊娠治疗中采用腹腔镜手术具有较好的临床效果,切口小,术后疼痛程度更低,术中出血量与排气时间更短,术后1年内再次妊娠率更高。
英文摘要:
      Objective:To investigate the clinical efficacy between laparoscopy and laparotomy in the treatment of ectopic pregnancy and the outcome of second pregnancy.Methods:93 cases of ectopic pregnancy treated in our hospital from November 2014 to December 2016 were selected as the subjects.According to the treatment methods, there were 45 cases of open surgery (laparotomy group), 47 cases of laparoscopy (laparoscopy group).The duration of operation, length of incision, intraoperative blood loss, exhaust time, HCG recovery time, hospitalization time, postoperative conception, pain and incidence of complications were compared between the two groups.Results:The operative time of the laparoscopy group was slightly more than that in the laparotomy group, but the difference was not statistically significant (P>0.05).The length of incision, the amount of bleeding in the operation, the time of exhaust, the time of HCG recovery and the time of hospitalization in the laparoscopy group were all lower than those in the laparotomy group, the difference was statistically significant (P<0.05).The VAS score of 6, 24,48 h after operation in the laparotomy group was higher than that in the laparoscopy group, the difference was statistically significant (P<0.05).The incidence of complications in the laparoscopy group(2.13%) was lower than the laparotomy group(13.33%), the difference was statistically significant (P<0.05). Postoperative tubal patency comparison and intrauterine pregnancy rate comparison in laparoscopy group was higher than the laparotomy group,but the difference was not statistically significant (P>0.05). The incidence of recurrent ectopic pregnancy within 1 year in the laparoscopic group was lower than that the laparotomy group, the difference statistically significant (P<0.05), and there was no was statistically significance in the rate of unpregnancy(P>0.05).Conclusion: Laparoscopic surgery has a good clinical effect in the treatment of ectopic pregnancy.The incision is small, postoperative pain is lower, the amount of bleeding and exhaust time is shorter, and the second pregnancy rate is higher within 1 year after operation.
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