腹腔镜在输卵管妊娠低血容量休克中的临床应用研究  

CLINICAL APPLICATION STUDY OF LAPAROSCOPIC OPERATION ON TUBAL PREGNANCY WITH HYPOVOLEMIC SHOCK

作　　者：陈全娘[1] 张晓薇[1] 邓志校[1] 胡淑君[1] 吴润德[1] 

机构地区：[1]广州医学院第一附属医院,510120

出　　处：《中国内镜杂志》2002年第8期26-27,30,共3页China Journal of Endoscopy

摘　　要：目的 :探讨腹腔镜手术在输卵管妊娠发生低血容量休克中的应用可能性及其价值。方法 :对 2 0例输卵管妊娠伴低血容量休克行腹腔镜手术的观察组 ,与 2 6例无休克腹腔镜手术的对照组病例 ,就其术式、手术时间、术后住院天数及总治疗费用等作比较研究。结果 :观察组保留输卵管率 95 .0 % (19/ 2 0 ) ,对照组为 10 0 % (2 6 /2 6 )。观察组腹腔积血量为 (175 6 .2 5± 4 99.90 )ml,对照组为 (332 .6 9± 2 0 2 .5 1)ml,两组比较有极显著性差异(P <0 .0 0 1)。观察组输血量为 (717.5 0± 338.4 5 )ml,而对照组均无输血。观察组手术时间 (14 5 .5 7± 5 2 .82 )min ,和对照组 (12 5 .19± 5 8.0 8)min比较无差异 (P >0 .0 5 )。观察组总治疗费用 (90 37.6 5± 170 5 .0 3)元 ,比对照组 (6 82 1.32± 1715 .13)元高 (P <0 .0 0 1)。两组术后住院天数相仿 ,分别为 (6 .75± 1.5 9)d和 (6 .5 0± 2 .2 7)d ,(P >0 .0 5 )。结论 :输卵管妊娠并低血容量休克患者在补充血容量、纠正休克 ,后仍然是腔镜腹手术的适应证。Objective:To study whether the patients with tubal pregnancy associated with large amount of intraperitoneal hemorrhage and hypovolemic shock is the indication of laparoscopic operation or not.Methods:To compare the clinical effects of observation group with control group.All patients in the observation group (20 cases) with hypovolemic shock and in the control group (26 cases) without hypovolemic shock underwent laparoscopic surgery.To compare the mode of operation,operation time,days of postoperation hospital stay and average hospitalization cost and so on.Results:Twenty cases in the observation group to saved the damaged uterine tube rate was 95.0% and in the control group was 100%.The average volume of hematoperitoneum was (1756.25±499.90)ml in observation group and (332.69±202.51)ml in control group ( P <0.001).The average supplementing volume blood was (717.50±338.45)ml in observation group and there was no case need blood transfusion in control group.The average hospitalization cost was (9037.65±1705.03) Yuan in observation group and (6821.32±1715.13) Yuan in control group.There was no difference in operation time and the days of postoperation hospital stay between the observation group and the control group( P >0.05).Conclusions:The patients suffering from tubal pregnancy associated with large amount of intraperitoneal hemorrhage and hypovolemic shock can be performed laparoscopic surgery without removing uterine tube after supplementing volume blood by the way of blood transfusion and fluid infusion and improving hypovolemic shock.It is suitable for these patients to perform salpingostomy saving the damaged utering tube under laparoscopy.

关 键 词：临床应用 腹腔镜手术 输卵管妊娠 低血容量休克 

分 类 号：R714.221[医药卫生—妇产科学]