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目的探讨气腹腹腔镜和无气腹腹腔镜治疗异位妊娠的效果。方法选择2012年10月—2015年10月中国人民解放军第一一三医院无气腹腹腔镜治疗的输卵管妊娠患者75例和气腹腹腔镜治疗的异位妊娠患者75例作为研究对象,比较2组患者术前盆腔出血量、术中出血量、手术时间、术后排气时间、术后疼痛情况、术后住院时间、住院费用、术后并发症情况以及手术前后血气分析情况。结果无气腹腹腔镜组异位妊娠患者的手术时间为(32.49±21.06)min、术后排气时间为(11.79±3.78)h、住院费用为(6 897.34±205.31)元、术后恶心呕吐和肩背部疼痛的发生率为36.0%和6.7%,均低于气腹腹腔镜组的(49.35±24.56)min、(16.52±4.34)h、(7 891.24±179.86)元、66.7%和26.7%(P<0.05)。2组异位妊娠患者手术开始后10 min和手术结束时pH值、PO_2和SaO_2均低于手术开始前(P<0.05),PaCO_2高于手术开始前(P<0.05);无气腹腹腔镜组异位妊娠患者手术开始后10min和手术结束时pH值、PO_2和SaO_2均高于气腹腹腔镜组(P<0.05),PaCO_2低于气腹腹腔镜组(P<0.05)。结论无气腹腹腔镜治疗异位妊娠能够缩短手术时间、术后排气时间,减少住院费用,减少术后并发症的发生率,对血气分析的影响小,值得在临床中推广。
Objective To investigate the effect of pneumoperitoneum laparoscopy and pneumoperitoneum laparoscopy in the treatment of ectopic pregnancy. Methods Seventy-five patients with tubal pregnancy without pneumoperitoneal laparoscopy and 75 patients with pneumoperitoneum laparoscopic pneumoperitoneum treated by the First Hospital of Chinese PLA from October 2012 to October 2015 were selected as research objects. Preoperative pelvic hemorrhage, intraoperative blood loss, operation time, postoperative exhaust time, postoperative pain, postoperative hospital stay, hospitalization costs, postoperative complications and blood gas analysis before and after surgery. Results The operation time of patients without pneumoperitoneal laparoscopic ectopic pregnancy was (32.49 ± 21.06) min, the time of postoperative exhaust was (11.79 ± 3.78) h, the cost of hospitalization was (6 897.34 ± 205.31) Yuan, postoperative nausea and vomiting And shoulder pain were 36.0% and 6.7% respectively, which were all lower than those in pneumoperitoneum group (49.35 ± 24.56) min, (16.52 ± 4.34) h, (7 891.24 ± 179.86) yuan, 66.7% and 26.7% (P <0.05). The pH value, PO_2 and SaO_2 of the ectopic pregnancy group were lower than those before operation (P <0.05) and PaCO_2 was higher than that before the operation (P <0.05) at 10 min after operation and at the end of operation. In the group of ectopic pregnancy, the pH value, PO_2 and SaO_2 were significantly higher than those in the pneumoperitoneum group (P <0.05) and PaCO_2 group was lower than those in the pneumoperitoneum group (P <0.05) at 10 min and at the end of the operation. Conclusion Laparoscopic pneumoperitoneum without ectopic pregnancy can shorten the operation time, postoperative exhaust time, reduce the cost of hospitalization and reduce the incidence of postoperative complications, blood gas analysis is small, it is worth to promote in the clinic.