输卵管妊娠应用悬吊式无气腹腹腔镜的临床干预研究  

A Study of clinical intervention of gasless laparoscopy in the treatment of tubal pregnancies

作　　者：薛夫营[1] 

机构地区：[1]山东省泰安市中心医院产科,山东泰安271000

出　　处：《中国医药科学》2014年第17期36-39,共4页China Medicine And Pharmacy

摘　　要：目的研究输卵管妊娠应用悬吊式无气腹腹腔镜的临床干预疗效。方法临床组行双孔悬吊式无气腹腹腔镜实施开窗取胚术或输卵管切除术,气腹组行常规腹腔镜CO2气腹下实施开窗取胚术或输卵管切除术。比照两组的手术耗时、失血量,术后排气时间、住院时间,并发症,评价两组实施开窗取胚术患者输卵管通畅率。结果所有患者手术顺利。临床组手术耗时显著少于气腹组。两组术后失血量、肛门排气时间及术后住院时间相比无显著差异。临床组术后疼痛发生率显著低于气腹组。两组术后高热及皮下气肿发生率相比较无显著差异。临床组实施开窗取胚术的46例中,25例输卵管复畅、21例阻塞,故通畅率54.35%;气腹组实施开窗取胚术的47例中,16例输卵管复畅,31例阻塞,故通畅率34.04%,临床组输卵管再通率显著高于气腹组。结论输卵管妊娠应用悬吊式无气腹腹腔镜疗效确切,可显著降低术后疼痛率,并且保留输卵管患者可有效提高其术后输卵管通畅率。ObjectiveTo explore the curative effect of clinical intervention of gasless laparoscopy in the treatment of tubal pregnancies.Methods The clinical group received fenestration of taking embryo or salpingectomy via two-port gasless laparoscopy,and the pneumoperitoneum group received fenestration of taking embryo or salpingectomy via regular laparoscopy under CO2 pneumoperitoneum.Surgery time,amount of bleeding,time of passage of gas,hospitalization time and complications were compared between the two groups,and tubal patency rate of patients receiving fenestration of taking embryo was evaluated in the two groups. Results The surgery was successful in all patients.Surgery time in the clinical group was significantly shorter than that in the pneumoperitoneum group. Postoperative amount of bleeding,time of passage of gas and hospitalization time were not significantly different between the two groups.Incidence of pain in the clinical group was significantly lower than that in the pneumoperitoneum group. Incidences of postoperative fever and subcutaneous emphysema were not significantly different between the two groups. 25 of 46 patients in the clinical group receiving fenestration of taking embryo achieved tubal patency, 21 patients showed tubal obstruction,and the patency rate was 54.35%;16 of 47 patients in the pneumoperitoneum group receiving fenestration of taking embryo achieved tubal patency,31 patients showed tubal obstruction,and the patency rate was 34.04%.Patency rate in the clinical group was significantly higher than that in the pneumoperitoneum group.Conclusion Gasless laparoscopy in the treatment of tubal pregnancies has an exact curative effect of significantly reducing postoperative pain and improving tubal patency rate for patients retaining Fallopian tubes.

关 键 词：输卵管妊娠 无气腹腹腔镜 术后疼痛 输卵管通畅率 

分 类 号：R713[医药卫生—妇产科学]