急诊腹腔镜联合自体血液回收机救治休克型异位妊娠

目的:研究急诊腹腔镜手术联合自体血液回收机救治休克型异位妊娠的安全性和有效性。方法:采用回顾性队列研究的方法,对我院2008-01～2011-12间急诊腹腔镜或开腹手术联合自体血液回收机救治休克型异位妊娠患者的一般资料、手术效果、术后恢复情况及术中术后并发症进行比较。其中腹腔镜手术32例,开腹手术24例。结果:①腹腔镜组自体血回输速度快(22.3±4.0)min vs(40.9±4.5)min、异体输血率低(11.8%vs 38.5%)、术后体温恢复快(3.3±0.9)d vs(4.8±1.3)d、住院天数短(4.7±1.1)d vs 5.8±1.2)d,与开腹组比较具有显著差异(P<0.05);②两组自体血回输量、术后血红蛋白、术后最高体温及住院费用之间无显著差异,两组术中术后均无严重并发症。结论:急诊腹腔镜联合自体血液回收机可快速有效回输自体血,显著减少异体输血,使腹腔镜手术治疗休克型异位妊娠更为安全有效。

Ectopic pregnancy with hemorrhagic shock treated by emergency laparoscopy combined with intraoperative autotransfusion

Objective： To investigate the safety and efficacy of ectopic pregnancy with hemorrhagic shock treated by emergency laparoscopy combined with the intraoperative autotransfusion devices. Methods： Retrospective cohort study method was used to analyze and compare the data of patients with ectopic pregnancy and hemorrhagic shock treated by emergency laparoscopy or laparotomy combined with intraoperative autotransfusion devices in Urumqi General Hospital from January 2008 to December 2011, 32 cases received laparoscopic operation and 24 cases received laparotomy. Results： Emergency laparoscopy combined with the intraoperative autotransfusion devices for ectopic pregnancy with hemorrhagic shock provided a quicker intraoperative autotransfusion （ 22.3 ± 4.0 ） rain vs （40.9 ± 4.5） rain, minimized the possibility of allogenic transfusion （11.8% vs 38.5% ）, and thus ensured the safety compared with that of the laparotomy group. There was no significant difference in intraoperative autotransfusion volume, hemoglobin, hyperpyrexia, and cost of hospitalization in the two groups, severe complication was also not found in both groups. Conclusion： Ectopic pregnancy with hemorrhagic shock can be treated safely and effectively by emergency laparoscopy combined with intraoperative autotransfusion devices.