腹腔镜治疗休克型输卵管妊娠的临床分析  

Clinical Analysis of Tubal Pregnancy with Shock Treated by Laparoscopic Surgeriy

作　　者：汪炼 凌玲 向世碧 龚旭华 凌萝达[2] 

机构地区：[1]重庆市江北区第一人民医院,重庆400020 [2]重庆医科大学附属第二医院,重庆400010

出　　处：《实用妇产科杂志》2002年第5期301-303,共3页Journal of Practical Obstetrics and Gynecology

摘　　要：目的 :探讨腹腔镜手术治疗休克型输卵管妊娠的经过和结局。方法 :5 2例休克型输卵管妊娠随机分为腹腔镜手术组 (研究组 2 2例 )和开腹手术组 (对照组 30例 )。研究组在镜下对已生育者行输卵管切除手术 ,对未育者行输卵管线形切开取胚保守性手术 ,对照组采用传统手术方法。结果 :5 2例休克型输卵管妊娠患者全部抢救成功 ,无并发症发生。腹腔镜组与开腹组平均手术时间比较 ,分别为 5 2 .2 7分种和 70 .5 0分种 ,平均住院时间分别为 4 .0天和 6 .6天 ,腹腔镜组均低于开腹手术组。手术方式的选择 ,腹腔镜组采用病灶切除和病灶切开取胚术二种手术方式的比例分别为 5 4 .5 %和4 5 .5 % ,开腹手术组的比例分别为 93.3%和 6 .7% ,对保守性手术的选择腹腔镜组明显高于开腹手术组 (P<0 .0 1)。结论 :休克型输卵管妊娠的手术抢救 ,在抗休克同时行腹腔镜手术是安全有效的 ;腹腔镜与传统开腹手术相比较 ,有手术时间短。Objectives:To evaluate the course and outcome of lapascopic operation on the therapy of tubal pregnancy with shock.Methods:Fifty two cases of tubal pregnancy with shock were divided into two groups:lapascopic operation(study group)and intraabdominal operation(control group).Salpingotomy was given to women who desire to keep their reproductive capability and salpingectomy was performed in women that complete labor.The traditional operation was adopted in control group.Results:All patients were survival without complications.The mean operative time was 52.27 min and 70.50 min in study group and control group,respectively.The hospitalization days were 4.0 and 6.6,respectively.By comparing these data,the study group was shorter than contral group.In the proportion of salpingectomy and salpingotomy,the study group was 54.5% and 45.5%,the control group was 93.3%and 6.7%.The lapascopic surgery operated more salpingectomy than control group( P <0.01).Conclusions:Lapascopic operation is safe and utility in patients with tuabl pregnancy and shock,and superior to intra abdominal surgery on the shortened surgery time,reduced hospitalization days,and highly successful salpingectomy.

关 键 词：失血性休克 输卵管妊娠 腹腔镜手术 硬膜外麻醉 

分 类 号：R714.221[医药卫生—妇产科学]