加速康复外科下腹腔镜手术治疗输卵管妊娠的临床效果研究  

Clinical effect of laparoscopic surgery for tubal pregnancy in enhanced recovery after surgery

作　　者：陈冰洁 庞爱军 CHEN Bingjie;PANG Aijun(Xi′an People′s Hospital·Xi′an Fourth Hospital:Department of Family Planning,Xi′an 710004,China;Xi′an People′s Hospital·Xi′an Fourth Hospital:Department of Critical Care Medicine,Xi′an 710004,China)

机构地区：[1]西安市人民医院·西安市第四医院计划生育科,陕西西安710004 [2]西安市人民医院·西安市第四医院重症医学科,陕西西安710004

出　　处：《西北国防医学杂志》2021年第7期667-671,共5页Medical Journal of National Defending Forces in Northwest China

基　　金：陕西省社会发展科技攻关项目(2019SF135)。

摘　　要：目的:研究加速康复外科下腹腔镜手术治疗输卵管妊娠的临床效果。方法:选取我院2019-06~2020-06收治的输卵管妊娠患者100例,按随机数字表分为传统开腹手术组(开腹组,n=50)和加速康复外科下腹腔镜手术组(ERAS组,n=50)。统计两组患者的手术时间、术中出血量、术后排气时间、下床活动时间和平均住院时间。比较两组患者术后并发症、炎性反应及免疫功能的情况。结果:ERAS组手术时间、术中出血量、术后排气时间、下床活动时间和平均住院时间均优于开腹组(P<0.05)。ERAS组术后总并发症发生率低于开腹组(20.0%vs 6.0%,P<0.05)。时间与方法在CRP和IL-6上不存在交互作用(P>0.05);时间与方法在CRP和IL-6上主效应显著(P<0.05)。时间与方法在CD3+、CD4+、CD8+和CD4+/CD8+上不存在交互作用(P>0.05);时间与方法在CD8+上主效应不显著(P>0.05);时间与方法在CD3+、CD4+和CD4+/CD8+上主效应显著(P<0.05)。结论:ERAS下腹腔镜手术治疗输卵管妊娠的患者术后恢复快,住院时间短,并发症少,对患者机体的炎症应激及免疫功能影响小。Objective:To study the clinical effect of enhanced recovery after surgery for tubal pregnancy under laparoscopic surgery.Methods:A total of 100 cases with tubal pregnancy from June,2019 to June,2020 in our hospital were selected.According to the random number table,the patients were divided into two groups:the patients who underwent traditional open surgery(open group,50 cases)and patients who underwent laparoscopic surgery under enhanced recovery after surgery(ERAS group,50 cases).The differences of operation time,intraoperative blood loss,postoperative exhaust time,time out of bed activity and average length of stay were statistically analyzed between the two groups.The postoperative complications,inflammatory reaction and immune function of the two groups were compared.Results:The operation time,intraoperative blood loss,postoperative exhaust time,ambulation time and average hospitalization time of ERAS group were better than those of open group(P<0.05).The incidence of postoperative complications in ERAS group was significantly lower than that in open group(20.0%vs 6.0%,P<0.05);No significant interaction was found in CRP and IL-6 between time and method(P>0.05);Main effects of time and method were significant in CRP and IL-6(P<0.05).No significant interaction was found in CD3+,CD4+,CD8+or CD4+/CD8(P>0.05);main effects of time and method were not significant in CD8+(P>0.05),main effects of time and method were significant in CD3+,CD4+or CD4+/CD8+(P<0.05).Conclusion:The patients with tubal pregnancy treated with ERAS had fast postoperative recovery,short hospital stay,fewer complications,and little impact on the body′s inflammatory stress and immune function.

关 键 词：输卵管妊娠 加速康复外科 腹腔镜手术 并发症 免疫功能 

分 类 号：R714.2[医药卫生—妇产科学]