摘要
目的 分析采用低气腹压腹腔镜治疗体外受精-胚胎移植（IVF-ET）术后早孕并异位妊娠的可行性,探讨其临床适用性。方法 选择2011年5月~2015年8月于广东省普宁华侨医院就诊治疗的IVF-ET术后早孕并发异位妊娠的患者46例,其中采用低气腹压腹腔镜治疗的患者24例（腹腔镜组）,采用开腹治疗的患者22例（开腹组）。观察两组患者手术时间、术中出血量、术后肛门排气时间、术后腹痛时间及平均住院时间,随访两组患者的妊娠结局情况。结果 两组患者均顺利完成手术,腹腔镜组患者未进行中转开腹手术。腹腔镜组患者平均手术时间、术后肛门排气时间、术后腹痛时间及住院时间均显著少于开腹组[（25.5±8.5）min vs（44.6±8.4）min,（19.8±7.2）h vs（42.1±7.9）h,（8.9±3.1）h vs（12.2±2.8）h,（6.6±2.4）d vs（11.5±2.5）d,P〈0.05],且术中的出血量也少于开腹组患者[（28.2±8.8）ml vs（56.9±9.1）ml,P〈0.01],两组患者均足月分娩,未出现流产及出生新生儿畸形情况;腹腔镜组患者平均孕龄为（38.2±2.8）周,开腹组患者平均孕龄为（38.5±2.5）周,差异无统计学意义（t=0.3820,P=0.7043）;腹腔镜组患者新生儿平均体重为（3.25±1.15）kg,开腹组患者新生儿平均体重为（3.53±1.17）kg,差异无统计学意义（t=0.8181,P=0.4177）,腹腔镜组患者新生儿Apgar评分为（8.7±1.3）分,开腹组患者新生儿Apgar评分为（8.9±1.1）分,差异无统计学意义（t=0.5606,P=0.5779）。结论 低气腹压腹腔镜治疗IVF-ET术后早孕并异位妊娠手术时间短,出血量少,术后恢复时间短,安全性高,具有临床可行性。
Objective To analyze the viability of low gas abdominal laparoscopic in the treatment of ectopic gestation after vitro fertilization-embryo transfer（IVF-ET）.Methods Forty-six cases of ectopic gestation pregnancy patients after IVF-ET concurrent were selected from May 2011 to August 2015 in Puning Overseas Chinese Hospital,and 24 patients were given the low gas abdominal laparoscopic treatment（laparoscopic group）,while the other 22 patients were given the abdominal treatment（open surgery group）.The operative time,blood loss,postoperative anal exhaust time,postoperative pain and mean hospital stay time of patients in the two groups were observed;and the pregnancy outcome of patients in the two groups was followed-up.Results Patients of the two groups were successfully operated,there was no patients in the laparoscopic group converted to open surgery.The mean operative time,anal exhaust time,postoperative pain time and the average length of stay of the laparoscopic group were significantly less than those of the open surgery patients[（25.5±8.5） min vs（44.6±8.4） min,（19.8±7.2） h vs（42.1±7.9） h,（8.9±3.1） h vs（12.2±2.8） h,（6.6±2.4） d vs（11.5±2.5） d,P〈0.01],and the intraoperative blood loss was also less than the open surgery group [（28.2±8.8） ml vs（56.9±9.1） ml,P〈0.05],patients were full-term birth,miscarriage and without newborn deformities;the mean gestational age of the laparoscopic group was（38.2±2.8） weeks,and the open surgery group was（38.5±2.5） weeks,had no statistically significant difference（t=0.3820,P=0.7043）;the average weight of neonatal patients in the laparoscopic group was（3.25±1.15） kg,the surgery group was（3.53±1.17） kg,had no statistically significant difference（t=0.8181,P=0.4177）;Apgar score of the laparoscopic group was（8.7±1.3） points,the open surgery group was（8.9±1.1） min,also had no statistically significant difference（t=0.5606,P=0.5779）.Conclusion Low gas abdominal laparoscopic can shorter the operative time,decrease the bleeding and postoperative recovery time in the treatment of ectopic gestation after IVF-ET,also with high safety,has clinical feasibility.
出处
《中国当代医药》
2016年第32期93-95,共3页
China Modern Medicine
