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目的探讨腹腔镜治疗异位妊娠并出血性休克的有效性、安全性和可行性。方法回顾性分析异位妊娠并出血性休克腹腔镜组67例和开腹组52例的住院时间、手术时间、进腹时间、术中出血量、术后肛门排气时间及并发症等。结果腹腔镜组手术时间为(42.0±7.0)min,与开腹组(45.0±12.0)min相比,差异无统计学意义(P>0.05);腹腔镜组术中出血量平均为(34.0±17.0)ml,与开腹组(42.0±7.0)ml相比,差异有统计学意义(P<0.01);进腹时间腹腔镜组为(1.5±1.0)min,明显短于开腹组(6.5±1.0)min(P<0.01);术后肛门排气时间腹腔镜组为(13.5±4.5)h,短于开腹组(37.5±12.5)h(P<0.01);住院时间腹腔镜组为(4.22±1.20)d,明显短于开腹组(6.74±1.67)d(P<0.01)。两组患者均未发生术中及术后并发症和死亡。结论在有效抗休克及完善的生命体征监护及麻醉管理下,结合熟练的腹腔镜操作技术进行腹腔镜手术治疗异位妊娠并出血性休克是安全、有效和可行的。
Objective To investigate the effectiveness, safety and feasibility of laparoscopic treatment of ectopic pregnancy and hemorrhagic shock. Methods Retrospective analysis of 67 cases of ectopic pregnancy and hemorrhagic shock laparoscopic group and open group of 52 cases of hospital stay, operation time, abdominal time, intraoperative blood loss, postoperative anal exhaust time and complications. Results The operation time of laparoscopic group was (42.0 ± 7.0) min, which was no significant difference compared with that of laparotomy group (45.0 ± 12.0) min (P> 0.05) 17.0) ml, which was significantly lower than that of the open group (42.0 ± 7.0) ml (P <0.01); the laparoscopic group was (1.5 ± 1.0) min, significantly shorter than the open group ± 1.0) min (P <0.01). The time of postoperative anal exhaust was (13.5 ± 4.5) h in the laparoscopic group, which was shorter than that in the open group (37.5 ± 12.5) h (4.22 ± 1.20) d, which was significantly shorter than that of the open group (6.74 ± 1.67) d (P <0.01). No intraoperative and postoperative complications and death occurred in either group. Conclusion Laparoscopic surgery combined with skilled laparoscopic techniques in the treatment of ectopic pregnancy and hemorrhagic shock is safe, effective and feasible under effective anti-shock and improved vital signs monitoring and anesthesia management.