自制单孔系统与传统腹腔镜手术治疗异位妊娠的疗效比较  

Comparative effectiveness of self-made single-port laparoscopy and traditional laparoscopy for ectopic pregnancy

作　　者：舒展[1] 王健[1] 郑冬媛 冯斌 郑彩霞[1] SHU Zhan;WANG Jian;ZHENG Dong-yuan(Department of Obstetrics and Gynecology,Tangshan Union Hospital,Tangshan 063006,China)

机构地区：[1]唐山市协和医院妇产科,河北唐山063006 [2]唐山市协和医院手术室

出　　处：《腹腔镜外科杂志》2022年第8期622-627,共6页Journal of Laparoscopic Surgery

基　　金：河北省医学科学研究课题计划(20211372)。

摘　　要：目的:探讨自制单孔入路腹腔镜手术与传统腹腔镜手术治疗异位妊娠(EP)的疗效。方法:选取2019年12月至2020年12月收治的92例EP患者进行前瞻性研究,根据随机数字表按入院次序编号,以简单随机化法分为单孔组(n=46)与传统组(n=46)。传统组行传统腹腔镜手术,单孔组采取自制入路系统行单孔腹腔镜手术。对比分析两组围手术期相关指标、并发症、疼痛评分、美容满意度(美容量表、身体意象量表)、应激代谢指标(皮质醇、游离三碘甲状腺原氨酸、游离甲状腺素)、卵巢储备功能(雌二醇、黄体生成素、卵泡刺激素)。结果:两组术中失血量、术后住院时间、排气时间、人绒毛膜促性腺激素转阴时间差异无统计学意义(P>0.05);单孔组手术时间长于传统组(P<0.05);两组并发症发生率差异无统计学意义(P>0.05);术后24 h单孔组疼痛评分低于传统组(P<0.05);术后1个月、3个月,单孔组美容量表、身体意象量表评分高于传统组(P<0.05);术后24 h单孔组血清皮质醇、游离三碘甲状腺原氨酸、游离甲状腺素水平低于传统组(P<0.05);术后1个月、3个月,两组血清雌二醇、黄体生成素、卵泡刺激素水平均低于术前(P<0.05),两组间差异无统计学意义(P>0.05)。结论:相较传统腹腔镜手术,自制入路单孔腹腔镜手术治疗EP安全、可行,具有创伤小、应激反应轻的优势,且未增加患者卵巢功能损伤。Objective:To discuss the curative effect of single port laparoscopy with self-made approach system and traditional laparoscopy in the treatment of ectopic pregnancy(EP).Methods:From Dec.2019 to Dec.2020,ninety-two EP patients were selected for prospective study,they were numbered in the order of admission according to the random number table,and were divided into single-port group(n=46)and traditional group(n=46)by simple randomization.The traditional group underwent traditional laparoscopic surgery,and the single-port group was treated with laparoscopic surgery with self-made single-port.Perioperative related i ndicators,complications,pain score,cosmetic satisfaction(cosmetic scale,body image scale),stress metabolism index(cortisol,free triiodothyronine,free thyroxine),ovarian reserve function(estradiol,luteinizing hormone,follicle stimulating hormone)were compared between the two groups.Results:There was no statistically significant difference between the two groups in terms of intraoperative blood loss,postoperative hospital stay,exhaust time and time for human chorionic gonadotropin to become negative(P>0.05).The operation time of the single-port group was longer than that of the traditional group(P<0.05).There was no statistically significant difference in the incidence of complications between the two groups(P>0.05).The pain score of the single-port group was lower than that of the t raditional group at 24 h after operation(P<0.05).The scores of cosmetic scale and body image scale in the single-port group at 1 month and 3 months after operation were higher than those in the traditional group(P<0.05).The serum levels of cortisol,free t riiodothyronine and free thyroxine in the single-port group were lower than those in the traditional group at 24 h after surgery(P<0.05).At 1 month and 3 months after operation,the levels of serum estradiol,luteinizing hormone and follicle stimulating hormone in the two groups were lower than those before operation(P<0.05),there was no statistically significant difference betw

关 键 词：妊娠 异位 腹腔镜检查 单孔 自制入路系统 治疗结果 

分 类 号：R713.8[医药卫生—妇产科学]