腹腔镜手术与开腹手术治疗异位妊娠疗效比较的系统评价

目的比较腹腔镜手术与开腹手术治疗异位妊娠的临床疗效及其临床应用价值。方法计算机检索PubMed、EMbase、SCI、Cochrane Library、中国生物医学文献数据库、中文科技期刊全文数据库、中国期刊全文数据库及中华医学会数字化期刊,收集腹腔镜手术与开腹手术治疗输卵管异位妊娠的随机对照试验,检索时间截止至2009年4月。由2名研究者独立按照纳入标准筛选文献、提取资料并交叉核对,而后采用Cochrane系统评价员手册4.2.6文献质量评价标准评价纳入研究质量,用RevMan 5.0软件进行Meta分析。结果共纳入11个研究,包括1795例患者。Meta分析结果显示,与开腹手术比较,腹腔镜手术并不能缩短手术操作时间,也不能减少手术并发症,但术中出血量和住院天数均少于开腹手术,肛门排气时间及下床活动时间均早于开腹手术。结论腹腔镜手术治疗异位妊娠优于开腹手术,不失为一种微创、可供选择使用的技术。

Laparoscopy versus Laparotomy for Ectopic Pregnancy:A Systematic Review

Objective To compare the surgical outcome and investigate the clinic value between laparoscopic operation and laparotomy in the treatment of ectopic pregnancy.Methods We searched PubMed,EMbase,SCI,The Cochrane Library,Chinese Biomedical Literature Database,China Journal Full Text Database,Chinese Medical Association Journals,and references of the included studies up to April 2009.Studies involving treatment outcome of ectopic pregnancy using laparoscopy compared with laparotomy were included.Data were extracted and methodological quality were evaluated by two reviewers independently with designed extraction form. The Cochrane Collaboration＇s RevMan 5.0.1 software was used for data analyses. Results A total of 11 studies involving 1795 patients were included. The results of meta-analyses showed that laparoscopy comparing with laparotomy; the operation time and complications had no difference; intraoperative blood loss was less than laparotomy; intestinal gas exhaust and evacuation active time was earlier than laparotomy. Conclusion Laparoscopy treating for ectopic pregnancy is better than laparotomy. It is a minimally invasive surgical technique, and is worthy to be popularized.