休克型输卵管妊娠腹腔镜手术临床分析

目的 :探讨腹腔镜手术用于治疗低血容量性休克的可行性和安全性。方法 :以 14例低血容量性休克患者为观察组 ,同期随机选择 30例无休克者为对照组 ,比较 2组腹腔积血量 ,手术时间 ,手术方式及术后住院天数。结果 :2组腹腔内出血量分别为 (15 16 6 7± 385 73)ml与 (15 0 75± 10 6 5 3)ml(P <0 0 5 ) ;手术时间 (5 9 17± 11 4 9)min与 (4 4 5± 14 2 3)min(P >0 0 5 ) ;住院天数分别为 (4 33± 0 98)d和 (4± 0 92 )d(P>0 0 5 )。两组患者术后均无并发症发生 ,恢复良好。除观察组 1例为输卵管保守性手术外 ,余均行输卵管切除术。结论 :只要有熟练的手术技巧和良好的麻醉监护 ,腹腔镜手术治疗低血容量性休克是可行的

Clinical analysis of laparoscopic operation on tubal pregnancy with hypovolemic shock

Objective:To evaluate the feasibility and safety of operative laparoscopy for tubal pregancy with hypovolemic shock.Methods:All patients in the observation group (14 cases) with hypovolemic shock and in the control group (30 cases) without hypovolemic shock underwent laparoscopic surgery. The intraabdominal blood loss,operation time, the mode of operation and the days of postoperation hospitalization were compared.Results:The intraabdominal blood loss was significantly (P<0 05)higher in patients with hypovolemic shock,1516.67±385 76ml versus 150.75±106.53ml;the operation time,59 17±11 49min versus 44 5±14 23min(P>0 05);The days of postoperation hospitalization,4.33±0.98d versus 4±0.92d(P>0.05);laparoscopic salpingectomy was perfomed in 92 8% of hypovolemic shock patients compared all stable patients. All patients had an uncomplicated postoperative course and made a full recovery. Conclusions:Improved anesthesia and advanced laparoscopic surgical skill and experience,justifies operative laparoscopy for surgical treatment of tubal pregnancy even in patients with hypovolemic shock.