摘要:
Objective To explore the clinical effect of the open and laparoscopic surgery in the treatment of ectopic pregnancy to retain the clinical efficacy of reproductive function analysis. Methods Four hundred and fifty-six patients with ectopic pregnancy were selected as our subjects. Two hundred and eleven cases were served as laparotomy group( open),and 245 cases were laparoscopic group( laparoscopic). The data of intraoperative blood loss,operative time,postoperative anal exhaust time,average hospital stay,tubal patency rate,intrauterine pregnancy rate and again repeat ectopic pregnancy rate were recorded. Results Patients in two groups were successfully completed surgery. The operative time,intraoperative blood loss,postoperative anal exhaust time,average hospitalization time were(55. 1 ± 13. 5)min,(63. 5 ± 18. 3)ml,(25. 7 ± 5. 6)h,(6. 1 ± 2. 0)d respectively in laparotomy group,and(41. 3 ± 15. 5)min,(41. 1 ± 13. 3)ml,(13. 5 ± 5. 1)h,(3. 6 ± 1. 4)d respectively in laparoscopic group,and the differences were significant( t =2. 045,2. 263,3. 131, 3. 152,P﹤0. 05). The tubal patency rate,intrauterine pregnancy,ectopic pregnancy rate in laparotomy group were 81. 0%( 171/211 ),59. 7%( 126/211 ) and 26. 5%( 56/211 ) respectively,and 75. 5%( 185/245 ), 53. 5%( 131/245 ) and 22. 9%( 56/245 ) respectively in laparoscopic group,and the differences were not significant(χ2 =2. 254,2. 130,1. 242;P ﹥0. 05 ). Conclusion Laparoscopic surgery in the treatment of ectopic pregnancy is superior to laparotomy in terms of small trauma,less bleeding,faster recovery,shorter hospitalization time,and postoperative tubal patency rate.%目的:回顾性分析开腹与腹腔镜手术治疗异位妊娠保留生育功能的临床效果,比较两种手术方式的优缺点。方法要求保留生育功能并接受手术治疗的异位妊娠患者456例,其中开腹手术211例(开腹组),腹腔镜手术245例(腹腔镜组)。比较两组术中出血量、手术时间、术后肛门排气时间、平均住院时间、输卵管通畅率、再次宫内妊娠率及重复异位妊娠率。结果两组均顺利完成手术。开腹组手术时间为(55.1±13.5)min,术中出血量为(63.5 ± 18.3)ml,术后肛门排气时间为(25.7±5.6)h,平均住院时间为(6.1±2.0)d;腹腔镜组分别为(41.3 ± 15.5)min、(41.1±13.3)ml、(13.5 ± 5.1)h、(3.6 ±1.4)d;两组比较差异均有统计学意义(t值分别为2.045、2.263、3.131、3.152,P均﹤0.05)。开腹组术后输卵管通畅率为81.0%(171/211),宫内受孕率59.7%(126/211),再次异位妊娠率26.5%(56/211);腹腔镜组分别为75.5%(185/245)、53.5%(131/245)、22.9%(56/245);两组比较差异均无统计学意义(χ2值分别为2.254、2.130、1.242,P均﹥0.05)。结论腹腔镜手术治疗异位妊娠创伤小、出血少、术后恢复快、住院时间短,疗效优于开腹手术。