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目的探讨腹腔镜手术治疗异位妊娠出血性休克患者的可行性以及感染发生及预防情况。方法 68例异位妊娠伴出血性休克患者,随机分为实验组与对照组,每组34例。所有患者在入院后均给予补充血容量、吸氧、保暖以及纠正休克的治疗,在此基础上对照组采用开腹手术,实验组采用腹腔镜手术,比较两组手术相关指标以及术后感染发生情况。结果两组患者术中最低血压、手术时间比较差异无统计学意义(P>0.05);实验组患者术中出血量、输血量显著低于对照组,差异具有统计学意义(P<0.05)。两组发热例数、发热持续时间比较差异无统计学意义(P>0.05);实验组胃肠功能恢复时间、下床活动时间和住院时间均显著短于对照组,差异具有统计学意义(P<0.05)。随访1个月,两组切口均为甲级愈合,实验组术后无感染发生,对照组有4例发生院内感染(11.76%),经对症抗感染处理已好转,两组感染发生情况比较,差异具有统计学意义(P<0.05)。结论在抗休克治疗的同时,采取腹腔镜手术,对异位妊娠出血性休克患者术后恢复以及减少感染发生方面具有显著效果,适合推广。
Objective To investigate the feasibility of laparoscopic surgery in patients with ectopic pregnancy hemorrhagic shock and the occurrence and prevention of infection. Methods 68 cases of ectopic pregnancy with hemorrhagic shock were randomly divided into experimental group and control group, 34 cases in each group. All patients were given blood volume after admission, oxygen, warm and correct the treatment of shock, on the basis of the control group using laparotomy, the experimental group using laparoscopic surgery, surgery-related indicators were compared between the two groups and postoperative infection Happening. Results There was no significant difference in the lowest blood pressure and operative time between the two groups (P> 0.05). The blood loss and blood transfusion in the experimental group were significantly lower than those in the control group (P <0.05). There was no significant difference in the number of fever between the two groups (P> 0.05). The recovery time of gastrointestinal function, ambulation time and length of hospital stay in the experimental group were significantly shorter than those in the control group (P> 0.05), and the difference was statistically significant <0.05). After one month of follow-up, the incisions of both groups were grade A healed. There was no postoperative infection in the experimental group, nosocomial infection occurred in 4 cases (11.76%) in the control group, symptomatic anti-infective treatment had been improved, The difference was statistically significant (P <0.05). Conclusion In the anti-shock treatment, laparoscopic surgery for patients with ectopic pregnancy hemorrhagic shock recovery and reduce the incidence of infection has a significant effect, suitable for promotion.