气腹腹腔镜和无气腹腹腔镜治疗异位妊娠的疗效观察  

Efficacy of routine laparoscopic and gasless laparoscopic management of ectopic pregnancy

作　　者：周琴[1] 王颖楠[1] 徐英姿[2] 

机构地区：[1]中国人民解放军第一一三医院妇产科,浙江宁波315040 [2]浙江省立同德医院妇科,浙江杭州310012

出　　处：《中华全科医学》2016年第10期1680-1682,共3页Chinese Journal of General Practice

基　　金：2015年浙江省医药卫生计划项目(2015KYA049)

摘　　要：目的探讨气腹腹腔镜和无气腹腹腔镜治疗异位妊娠的效果。方法选择2012年10月—2015年10月中国人民解放军第一一三医院无气腹腹腔镜治疗的输卵管妊娠患者75例和气腹腹腔镜治疗的异位妊娠患者75例作为研究对象,比较2组患者术前盆腔出血量、术中出血量、手术时间、术后排气时间、术后疼痛情况、术后住院时间、住院费用、术后并发症情况以及手术前后血气分析情况。结果无气腹腹腔镜组异位妊娠患者的手术时间为(32.49±21.06)min、术后排气时间为(11.79±3.78)h、住院费用为(6 897.34±205.31)元、术后恶心呕吐和肩背部疼痛的发生率为36.0%和6.7%,均低于气腹腹腔镜组的(49.35±24.56)min、(16.52±4.34)h、(7 891.24±179.86)元、66.7%和26.7%(P<0.05)。2组异位妊娠患者手术开始后10 min和手术结束时pH值、PO_2和SaO_2均低于手术开始前(P<0.05),PaCO_2高于手术开始前(P<0.05);无气腹腹腔镜组异位妊娠患者手术开始后10min和手术结束时pH值、PO_2和SaO_2均高于气腹腹腔镜组(P<0.05),PaCO_2低于气腹腹腔镜组(P<0.05)。结论无气腹腹腔镜治疗异位妊娠能够缩短手术时间、术后排气时间,减少住院费用,减少术后并发症的发生率,对血气分析的影响小,值得在临床中推广。Objective To discuss the effect of gasless laparoscopic and gasless laparoseopy treatment of ectopic pregnancy. Methods The gasless laparoscopy was performed in 75 cases of eetopic pregnancy in our hospital, while the routine laparoseopic management was carried out in another 75 cases of ectopie pregnancy as control. The preoperative pelvic bleeding, peroperative bleeding, operative time, time to exhaust, postoperative pain, postoperative hospital stay, hospital costs and postoperative complications and blood gas analysis of preoperative and postoperative in two groups were compared. Results The operative time was （ 32.49 ± 21.06 ） min, time to exhaust was （ 11.79 ± 3.78 ） h, hospitalization costs was （6 897.34 ± 205.31 ）Yuan, and the incidence of nausea and vomiting and incidence of shoulder and back pain （36.0%0 and 6.7% , respectively） in the observation group, which were lower than the control group [ （49.35±24.56 ） min, （ 16.52 ± 4.34） h, （7 891.24 ± 179.86） Yuan ,66.7% and 26.7% ] （ P 〈 0.05 ）. At 10 minutes after the beginning of surgery and the end of surgery, the pH value, PO2 and SaO2 in both groups were lower than those before the surgery （P 〈0.05） ,however,the PaCO2 were higher than before the surgery（ P 〈 0.05 ）. At 10 minutes after the beginning of surgery and the end of surgery, the pH value, PO2 and SaO2 in the observation group were lower than those in the control group （ P 〈 0. 05 ） , but the PaCO2 were higher （ P 〈 0.05 ）. Conclusion Gasless laparoseopic treatment for ectopie pregnancy can shorten the operation time and postoperative discharge time, reduce hospital costs, decrease the incidence of postoperative complications, with little effect on blood gas analysis,it is worth popularizing in clinic.

关 键 词：无气腹 腹腔镜 异位妊娠 气腹 

分 类 号：R714.22[医药卫生—妇产科学] R713.7[医药卫生—临床医学]