两种保守性手术治疗输卵管妊娠临床分析

目的:比较经腹腔镜与开腹保守性手术治疗输卵管妊娠的临床效果。方法:将146例确诊为输卵管妊娠、包块直径≤5cm且有生育要求的患者,随机分为腹腔镜组76例和开腹组70例,比较两组保守性手术手术时间、住院时间、术中出血量、手术成功率及术后血β-hCG恢复情况。结果:与开腹组相比,腹腔镜组手术成功率高(96.05%∶81.49%,P<0.05),术中出血少〔(32.7±14.3)ml∶(81.6±41.2)ml,P<0.05〕,手术时间短〔(41±19)min∶(57±12)min,P<0.05〕,住院时间短〔(4.9±0.8)天∶(7.0±2.3)天,P<0.05〕,肛门排气时间短〔(17.1±5.6)h∶(32.0±8.4)h,P<0.05〕,手术后血β-hCG恢复正常时间两组比较无显著差异(P>0.05)。结论:腹腔镜保守治疗输卵管妊娠具有手术时间短、术中出血少、术后患者肠道功能恢复迅速、住院时间短等优点,且手术成功率高,值得推广应用。

Clinical analysis of two kinds of conservative surgeries in treating tubal pregnancy

Objective:To compare the clinical effects in treating tubal pregnancy between operative laparoscopy and laparotomy.Methods:146 patients that diagnosed as tubal pregnancies,node diameter≤5 cm,who want to fertility,randomly divided into operative laparoscopy 76 cases and laparotomy 70 cases to compare two kinds of conservative surgeries on operative time,length of stay,bleeding in operation,rate of success and recover time of serum β-HCG after operation.Results:Compared laparotomy group,rate of success in operative laparoscopy were higher(96.05% vs 81.43%,P<0.05),bleeding in operation were less 〔(32.7±14.3)ml vs(81.6±41.2)ml,P<0.05〕,operative time were shorter〔(41±19)min vs(57±12)min,P<0.05〕,length of stay were shorter 〔(4.9±0.8)d vs(7.0±2.3)d,P<0.05〕,the functional recovery time of bowel were shorter 〔(17.1±5.6)h vs(32±8.4)h,P<0.05〕,recover time of serum β-HCG after operation had no significant difference(P>0.05)in two groups.Conclusion:Conservative surgeries of operative laparoscopy in treating tubal pregnancy is better than laparotomy on operative time,bleeding in operation,functional recovery time of bowel,and length of stay,also high rate success.So it is worth propagating.