腹腔镜下异位妊娠病灶清除术的治疗效果及对患者炎性反应指标和术后恢复的影响  

Effect of Laparoscopic Removal of Ectopic Pregnancy and its influence on Inflammatory Response Indexes and Postoperative Recovery

作　　者：张东霞 李文超[1] 白雨昕 ZHANG Dong-xia;LI Wen-chao;BAI Yu-xin(Department of Gynecology,Jiamusi Central Hospital,Jiamusi 154002,Heilongjiang,China)

机构地区：[1]佳木斯市中心医院妇科,黑龙江佳木斯154002

出　　处：《医学信息》2022年第11期121-123,共3页Journal of Medical Information

摘　　要：目的探讨腹腔镜下异位妊娠病灶清除术的治疗效果及对患者炎性反应指标和术后恢复的影响。方法选取2019年9月-2020年9月我院行异位妊娠病灶清除术患者78例,以随机数字表法分为OS组和LO组,每组39例。OS组行开腹手术,LO组行腹腔镜手术。比较两组临床手术指标(手术时间、术中出血量)、术后恢复指标(留置导尿管时间、排气时间、首次下床时间、住院时间)、不同时间(术后6、12、24、48、72 h)疼痛评分及炎性反应指标[血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、白介素-8(IL-8)]、输卵管疏通率及1年内宫内妊娠率。结果LO组手术时间、留置导尿管时间、排气时间、首次下床时间、住院时间短于OS组,术中出血量少于OS组(P<0.05);LO组术后6、12、24、48、72 h疼痛评分低于OS组(P<0.05);两组CRP、TNF-α、IL-6、IL-8水平高于术前,LO组低于OS组(P<0.05);LO组输卵管疏通率、1年内宫内妊娠率高于OS组(P<0.05)。结论腹腔镜下行异位妊娠病灶清除术治疗能够减轻术后疼痛,促进术后早期恢复,减轻炎性反应,也能够改善再次妊娠结局,应用效果优于开腹手术。Objective To investigate the therapeutic effect of laparoscopic removal of ectopic pregnancy lesions and its influence on patients'inflammatory response indexes and postoperative recovery.Methods A total of 78 patients with ectopic pregnancy treated in our hospital from September 2019 to September 2020 were randomly divided into OS group and LO group,with 39 cases in each group.OS group underwent open surgery,LO group underwent laparoscopic surgery.The clinical operation indexes(operation time,intraoperative blood loss),postoperative recovery indexes(indwelling catheter time,exhaust time,first getting out of bed time,hospitalization time),pain scores at different time points(6,12,24,48,72 h after operation)and inflammatory reaction indexes[serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8)],tubal patency rate and intrauterine pregnancy rate within 1 year were compared between the two groups.Results The operation time,indwelling catheter time,exhaust time,first getting out of bed time and hospitalization time in the LO group were shorter than those in the OS group,and the intraoperative blood loss was less than that in the OS group(P<0.05).The pain score of LO group was lower than that of OS group at 6,12,24,48 and 72 h after operation(P<0.05).The levels of CRP,TNF-α,IL-6 and IL-8 in the two groups were higher than those before operation,and those in the LO group were lower than those in the OS group(P<0.05).The tubal patency rate and 1-year intrauterine pregnancy rate in the LO group were higher than those in the OS group(P<0.05).Conclusion Laparoscopic removal of ectopic pregnancy lesions can relieve postoperative pain,promote early postoperative recovery,reduce inflammatory response,and improve the outcome of repregnancy,the application effect is better than that of laparotomy.

关 键 词：异位妊娠病灶清除术 腹腔镜 炎症因子 

分 类 号：R714.221[医药卫生—妇产科学]