改良经脐单孔腹腔镜下输卵管切开取胚术对输卵管异位妊娠患者疼痛程度及人绒毛膜促性腺激素复常时间的影响  

Influence of modified transumbilical single-port laparoscopic salpingotomy for embryo extractionon pain degree and human chorionic gonadotropin recovery time in patients with tubal ectopic pregnancy

作　　者：李凤 黄国婷 徐安娜 LI Feng;HUANG Guoting;XU Anna(Department of Obstetrics and Gynecology,Jingdezhen Maternal and Child Health Hospital,Jingdezhen,Jiangxi,333000,China)

机构地区：[1]景德镇市妇幼保健院妇产科,江西景德镇333000

出　　处：《当代医学》2023年第32期27-30,共4页Contemporary Medicine

摘　　要：目的探究改良经脐单孔腹腔镜下输卵管切开取胚术对输卵管异位妊娠患者疼痛程度及人绒毛膜促性腺激素(HCG)复常时间的影响。方法选取2019年2月至2021年2月景德镇市妇幼保健院收治的60例输卵管异位妊娠患者作为研究对象,按抽签法分为常规组与观察组,每组30例。常规组采用常规腹腔镜下输卵管切开取胚术,观察组采用改良经脐单孔腹腔镜下输卵管切开取胚术。比较两组围手术期指标、血清皮质醇(Cor)水平、视觉模拟评分法(VAS)评分、并发症发生情况及满意度。结果观察组手术时间长于常规组,住院时间、术后排气时间、HCG复常时间均短于常规组,术中出血量少于常规组,差异有统计学意义(P<0.05)。两组HCG水平时间比较差异有统计学意义(P<0.05);两组HCG水平组间、交互比较差异无统计学意义;两组Cor水平组间、时间、交互比较差异有统计学意义(P<0.05)。组内比较:术后3、5 d,两组HCG水平均低于术前,且术后5 d低于术后3 d,差异有统计学意义(P<0.05);术后24、72 h,两组Cor水平均高于术前,但术后72 h低于术后24 h,差异有统计学意义(P<0.05)。组间比较:术前,两组HCG、Cor水平比较差异无统计学意义;术后3、5 d,两组HCG水平比较差异无统计学意义;术后24、72 h,观察组Cor水平均低于常规组,差异有统计学意义(P<0.05)。术后3 d,两组VAS评分均低于术后1 d,术后1、3 d,观察组VAS评分均明显低于常规组,差异有统计学意义(P<0.05)。两组并发症发生率比较差异无统计学意义。观察组满意度明显高于常规组,差异有统计学意义(P<0.05);两组一般、不满意占比比较差异无统计学意义。结论改良经脐单孔腹腔镜下输卵管切开取胚术治疗输卵管异位妊娠效果显著,可降低患者机体应激反应,减轻疼痛程度,缩短HCG复原时间,促进患者恢复,值得临床推广应用。Objective To explore the influence of modified transumbilical single-port laparoscopic salpingotomy for embryo extraction on pain degree and human chorionic gonadotropin(HCG)recovery time in patients with tubal ectopic pregnancy.Methods 60 patients with tubal ectopic pregnancy admitted to Jingdezhen Maternal and Child Health Hospital from February 2019 to February 2021 were enrolled as the research subjects,and they were divided into the conventional group and the observation group according to the lottery method,with 30 cases in each group.The conventional group was treated with conventional laparoscopic salpingotomyfor embryo extraction,and the observation group was given modified transumbilical single-port laparoscopic salpingotomy for embryo extraction.The perioperative indicators,serum cortisol(Cor)level,visual analogue scale(VAS)score,occurrence of complications and satisfaction were compared between the two groups.Results The surgical time in observation group was longer than that in conventional group,while the hospital stay,postoperative exhaust time and HCG recovery time were shorter than those in conventional group,and the intraoperative blood loss was less than that in the conventional group,the differences were statistically significant(P<0.05).There were statistically significant differences in HCG level between the two groups of time pionts(P<0.05);there was no significant difference in HCG level between the two groups and interaction;there were statistically significant differences in Cor level between the two groups of groups,time points and interaction(P<0.05).Comparison within groups:3 and 5 d after operation,HCG level of the two groups were lower than before surgery,and 5 d after operation was lower than 3 d after operation,the differences were statistically significant(P<0.05);at 24 and 72 h after operation,Cor levels of the two groups were higher than before operation,but at 72 h after surgery lower than at 24 h after operation,the differences were statistically significant(P<0.05).Compariso

关 键 词：输卵管异位妊娠 腹腔镜下输卵管切开取胚术 疼痛 

分 类 号：R713.8[医药卫生—妇产科学]