三种腹腔镜手术在异位妊娠治疗的临床对比研究  

A comparative study of three kinds of laparoscopic surgery in treatment of ectopic pregnancy

作　　者：赵玲 王亦雄[1] 张磊[1] 尚教伟 林莎莎 ZHAO Ling;WANG Yixiong;ZHANG Lei;SHANG Jiaowei;LIN Shasha(Department of Gynecology,Yangzhou Maternal and Child Care Service Centre,Affiliated to Yangzhou University Medical School,Yangzhou 225002,Jiangsu,China)

机构地区：[1]扬州大学医学院附属扬州市妇幼保健院妇科,江苏扬州225002

出　　处：《中国现代医生》2024年第13期21-24,共4页China Modern Doctor

基　　金：扬州市科技计划项目(YZ2020115)。

摘　　要：目的比较经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic surgery,v-NOTES)、经脐单孔腹腔镜手术(transumbilical laparoendoscopic single site surgery,TU-LESS)及传统腹腔镜手术治疗异位妊娠的疗效与差异。方法回顾性选取2019年6月至2022年6月扬州大学医学院附属扬州市妇幼保健院收治的异位妊娠患者121例,根据手术方式不同将纳入患者分为传统腹腔镜组(49例)、TU-LESS组(43例)和v-NOTES组(29例)。观察各组患者的年龄、体质量指数(body mass index,BMI)、血红蛋白(hemoglobin,Hb)、手术时间、术中出血、术后排气时间、术后24h视觉模拟评分法(visual analogue scale,VAS)评分、术后住院时间和满意度。结果v-NOTES组患者的排气时间、术后住院时间均显著短于传统腹腔镜组和TU-LESS组,术后24h VAS评分显著低于传统腹腔镜组和TU-LESS组(P<0.05);三组患者的术后满意度比较差异有统计学意义(H=57.364,P<0.001),且v-NOTES组>TU-LESS组>传统腹腔镜组。结论与TU-LESS和传统腹腔镜手术比较,v-NOTES治疗异位妊娠术后恢复快,疼痛轻,更加美观,但需要手术者熟练掌握。Objective To compare the efficacy and difference of transvaginal natural orifice transluminal endoscopic surgery(v-NOTES),transumbilical laparoendoscopic single site surgery(TU-LESS)and traditional laparoscopic surgery in the treatment of ectopic pregnancy.Methods A total of 121 patients with ectopic pregnancy admitted to Yangzhou Maternal and Child Care Service Centre,Affiliated to Yangzhou University Medical School from June 2019 to June 2022 were retrospectively selected.According to different surgical methods,the included patients were divided into traditional laparoscopic group(49 cases),TU-LESS group(43 cases)and v-NOTES group(29 cases).Age,body mass index(BMI),hemoglobin(Hb),operation time,intraoperative bleeding,postoperative exhaust time,and 24h postoperative visual analogue scale(VAS)score,postoperative hospital stay and satisfaction of patients in each group were observed.Results The exhaust time and postoperative hospital stay in v-NOTES group were significantly shorter than those in traditional laparoscopic group and TU-LESS group,and 24h postoperative VAS score was significantly lower than that in traditional laparoscopic group and TU-LESS group(P<0.05).There was significant difference in postoperative satisfaction among three groups(H=57.364,P<0.001),and v-NOTES group>TU-LESS group>traditional laparoscopic group.Conclusion Compared with TU-LESS and traditional laparoscopic surgery,v-NOTES treatment of ectopic pregnancy recovery faster,less pain,more beautiful appearance,but need to be mastered by the operator.

关 键 词：经阴道自然腔道内镜手术 经脐单孔腹腔镜手术 传统腹腔镜手术 异位妊娠 

分 类 号：R715[医药卫生—妇产科学]