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三种腹腔镜手术在异位妊娠治疗的临床对比研究OA

A comparative study of three kinds of laparoscopic surgery in treatment of ectopic pregnancy

中文摘要英文摘要

目的 比较经阴道自然腔道内镜手术(transvaginal natural orifice transluminal endoscopic surgery,v-NOTES)、经脐单孔腹腔镜手术(transumbilical laparoendoscopic single site surgery,TU-LESS)及传统腹腔镜手术治疗异位妊娠的疗效与差异.方法 回顾性选取 2019 年 6 月至 2022 年 6 月扬州大学医学院附属扬州市妇幼保健院收治的异位妊娠患者 121例,根据手术方式不同将纳入患者分为传统腹腔镜组(49 例)、TU-LESS组(43 例)和v-NOTES组(29 例).观察各组患者的年龄、体质量指数(body mass index,BMI)、血红蛋白(hemoglobin,Hb)、手术时间、术中出血、术后排气时间、术后 24h视觉模拟评分法(visual analogue scale,VAS)评分、术后住院时间和满意度.结果 v-NOTES组患者的排气时间、术后住院时间均显著短于传统腹腔镜组和TU-LESS组,术后 24h VAS评分显著低于传统腹腔镜组和TU-LESS组(P<0.05);三组患者的术后满意度比较差异有统计学意义(H=57.364,P<0.001),且v-NOTES组>TU-LESS组>传统腹腔镜组.结论 与TU-LESS和传统腹腔镜手术比较,v-NOTES治疗异位妊娠术后恢复快,疼痛轻,更加美观,但需要手术者熟练掌握.

Objective To compare the efficacy and difference of transvaginal natural orifice transluminal endoscopic surgery(v-NOTES),transumbilical laparoendoscopic single site surgery(TU-LESS)and traditional laparoscopic surgery in the treatment of ectopic pregnancy.Methods A total of 121 patients with ectopic pregnancy admitted to Yangzhou Maternal and Child Care Service Centre,Affiliated to Yangzhou University Medical School from June 2019 to June 2022 were retrospectively selected.According to different surgical methods,the included patients were divided into traditional laparoscopic group(49 cases),TU-LESS group(43 cases)and v-NOTES group(29 cases).Age,body mass index(BMI),hemoglobin(Hb),operation time,intraoperative bleeding,postoperative exhaust time,and 24h postoperative visual analogue scale(VAS)score,postoperative hospital stay and satisfaction of patients in each group were observed.Results The exhaust time and postoperative hospital stay in v-NOTES group were significantly shorter than those in traditional laparoscopic group and TU-LESS group,and 24h postoperative VAS score was significantly lower than that in traditional laparoscopic group and TU-LESS group(P<0.05).There was significant difference in postoperative satisfaction among three groups(H=57.364,P<0.001),and v-NOTES group>TU-LESS group>traditional laparoscopic group.Conclusion Compared with TU-LESS and traditional laparoscopic surgery,v-NOTES treatment of ectopic pregnancy recovery faster,less pain,more beautiful appearance,but need to be mastered by the operator.

赵玲;王亦雄;张磊;尚教伟;林莎莎

扬州大学医学院附属扬州市妇幼保健院妇科,江苏扬州 225002

临床医学

经阴道自然腔道内镜手术经脐单孔腹腔镜手术传统腹腔镜手术异位妊娠

Transvaginal natural orifice transluminal endoscopic surgeryTransumbilical laparoendoscopic single site surgeryTraditional laparoscopic surgeryEctopic pregnancy

《中国现代医生》 2024 (013)

21-24 / 4

扬州市科技计划项目(YZ2020115)

10.3969/j.issn.1673-9701.2024.13.006

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