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目的评价妊娠期腹腔镜附件手术的效果及安全性。方法2000年4月至2005年9月将北京协和医院妇科妊娠期腹腔镜附件手术17例(早孕期3例,中孕期14例)列为研究组,同期同孕周范围开腹附件手术19例(早孕期2例,中孕期17例)列为对照组,比较两组附件手术期情况及妊娠结局。结果早孕期研究组3例术后孕期顺利,足月分娩。中孕期两组患者在术前情况、手术方式和术后病理等方面差异无显著性(P>0·05)。两组平均手术时间、术后出现宫缩例数、剖宫产率和新生儿体重差异均无显著性(P>0·05);术中平均出血量、术后疼痛率、镇痛药用药率、平均应用抗生素时间及平均术后住院日差异有显著性意义(P<0·05)。两组新生儿均无畸形和窒息。结论在正确掌握妊娠期腹腔镜附件手术指征的前提下,腹腔镜术式对比开腹术式不增加术中和术后并发症,并具有术中出血少,术后疼痛轻,用药少,住院时间短的优势。
Objective To evaluate the efficacy and safety of laparoscopic surgery in pregnancy. Methods From April 2000 to September 2005, 17 cases (3 in early pregnancy and 14 in middle pregnancy) of laparoscopic accessory operation of gynecological pregnancy in Peking Union Medical College Hospital were enrolled as study group. In the same period, 19 cases (Early pregnancy 2 cases, 17 cases of pregnancy) as a control group, the two groups were compared operative conditions and pregnancy outcomes. Results The early pregnancy study group 3 cases of postoperative pregnancy smoothly, full-term delivery. There was no significant difference in preoperative status, operation method and postoperative pathology between the two groups in the second trimester (P> 0.05). There was no significant difference between the two groups in the average operation time, the number of uterine contractions, the rate of cesarean section and the weight of neonates (P> 0.05); mean intraoperative blood loss, postoperative pain rate, analgesics Rate, the average application of antibiotics and the average postoperative hospital stay difference was significant (P <0. 05). Neither group had deformity and asphyxia. Conclusion In the correct grasp of laparoscopic gestational gestational indications under the premise of laparoscopic surgery compared with laparotomy does not increase intraoperative and postoperative complications, and has less bleeding, postoperative pain, less medication, Advantages of short hospital stay.