摘要
【目的】评价休克型异位妊娠患者采用腹腔镜手术治疗的临床效果并对其成本效果进行初步分析。【方法】选择本院 1997年 3月至 2 0 0 2年 3月间收治的休克型异位妊娠患者 76例 ,其中腹腔镜手术 2 6例 ,开腹手术 5 0例 ,比较分析两组患者围术期相关指标及住院直接医疗费用。【结果】腹腔镜组与开腹组手术类型及平均手术时间 [(6 7.34± 2 5 .10 )minvs (5 3.4 0± 12 .73)min]比较差异无显著性 (P >0 .0 5 ) ,1例间质部妊娠中转开腹。腹腔镜组术中回收自体血量 [(76 8± 34)mlvs (12 32± 5 6 )ml]较开腹组少 (P<0 .0 5 ) ,平均异体输血量 [(4 13± 2 2 4 )mlvs (2 0 8± 343)ml]则高于开腹组 (P <0 .0 5 )。术后平均住院天数 [(5 .5 2±1.0 8)dvs (6 .5 9± 1.71)d]比较两组差异无显著性 (P >0 .0 5 )。术后并发症发生率 (3.85 %vs 4 % )两组差异无显著性 (P >0 .0 5 )。平均住院费、手术费、输血费用腹腔镜组均高于开腹组 (P <0 .0 5 ) ,而治疗费两组差异无显著性 (P >0 .0 5 )。【结论】休克型异位妊娠患者采用腹腔镜手术治疗是可行的 ,但其积血及血块清除速度受限 ,腹腔镜手术的住院直接医疗成本较开腹手术高。
Objective To evaluate the clinical efficacy and cost of laparoscopic surgery in treatment of ectopic pregnancy (EP) patients with hypovolemic shock and.Seventy-six EP inpatients with hypovolemic shock admitted in our hospital from March 1997 to March 2002 were selected . They were randomly divided into two groups : 26 cases were treated with laparoscopic surgery and 50 cases were subjected to laparotomy. The related data in peri-operative period and cost during hospitalization were comparatively analyzed between two groups.Compared with laparotomy group , the laparoscopic surgery group had the similar type of operation and average operating time (67.34±25.10 min vs 53.40±12.73 min ; P>0.05) . Only one case of pregnancy within interstitial region (cornuate pregnancy) required shift to laparotomy. The average autohemic volume recovered in laparoscopic surgery was much less than that in laparotomy (768±34 ml vs 1232±56 ml ; P<0.05); while the average amount of allogenic blood transfusion in the former was significantly higher than that in the latter (413±224 ml vs 208±343 ml ; P<0.05). The duration of post-operative stay in hospital [ (5.52±1.08) d vs (6.59±1.71) d] and rate of complications(3.85% vs 4%) exhibited no remarkable differences between both groups (P>0.05). The charges of hospitalization, operation and blood transfusion in laparoscopic surgery was more expensive than those in laparotomy(P<0.05), but difference in charge of therapy between two groups revealed no statistical significance(P>0.05).[Conclusions]Laparoscopic operation is one of useful choice as laparotomy in the management of EP with hypovolemic shock, but its ability to clean up accumulated intra-abdominal blood and clots is limited. Moreover, its direct medication cost is much higher than that of laparotomy.
出处
《医学临床研究》
CAS
2004年第7期765-768,共4页
Journal of Clinical Research
关键词
妊娠
异位/外科学
外科手术
腹腔镜
pregnancy,ectopic/SU
surgical procedures,laparoscopic
