异位妊娠大出血的腹腔镜手术处理

目的：探讨异位妊娠大出血时行腹腔镜手术的可行性。方法：分析90例腹腔镜下异位妊娠的治疗方法、住院时间、手术时间、术中出血量及并发症。结果：90例均在腹腔镜下手术，无术时术后并发症，临床治愈率100％。90例中，按术前腹腔镜腔内积血量分为两组：腹腔内积血量300－2800ml者42例（I组），腹腔内积血量＜300ml者48例（＜Ⅱ组）。分别比较Ⅰ组和Ⅱ组的住院时间、手术时间、术中出血量等，经统计学处理，两组均无显著性差异（P＞0．05）。结论：异位妊娠大出血不是 腹腔镜手术的禁忌证。腹腔大量积血给手术增加了难度，只要术中处理得恰当，均能成功完成手术。

Laparoscopic Operation for Ectopic Pregnancy Complicated with Massive Intraabdominal Hemorrhage

Objective:To explore the feasibility of laparoscopic operation for ectopic pregnancy with massive hemorrhage.Methods:The surgical skills.operation time,hospital stay,blood loss and intra-and post-operation complications of laparoscopic operation were analyzed retrospectively in 90 patients with ectopic pregnancy.Results:All patients were operated successully without intra-and post-operation complications.90 cases were divided into two groups according to volume of hemoperitoneum.Volume of hemoperitoneum in 42 patients from 300ml to 2800ml (first group),volume less and 300ml in 48 cases (second group).The time of hospitalization,time of surgery,volume of hemorrhage during operation were respectively compared between two groups,and no significant difference was found between the two groups (P>0.05).Conclusions:Massive hemorrhage in ectopic pregnancy is not the contraindication of operative laparoscopy.The degree of difficulty was improved due to heavy hemoperitoneum.Howeve,the surgery can be performed successfully with appropriate measures during operation.