【作者】 张霞；

【导师】 陈友国；

【作者基本信息】 苏州大学 ， 妇产科学， 2013， 硕士

【摘要】 目的分析并探讨经脐单孔腹腔镜手术在诊治异位妊娠的安全性及可行性。方法选取2010年6月至2012年9月间，我院诊断为异位妊娠，接受腹腔镜手术治疗的患者共72例，术后确诊均为输卵管妊娠。LESS组26例，其中输卵管切开取胚术22例，输卵管切除术4例。CLS组46例，其中输卵管切开取胚术38例，输卵管切除术8例。比较两组患者年龄、BMI、手术时间、术中出血量、术后VAS疼痛评分、术后住院天数、围手术期并发症及术后患者腹壁美容满意度评分等指标。结果在开展初期，LESS组手术时间明显延长，在经过10-20例手术后，手术时间明显减少，与传统腹腔镜对比，并未增加手术时间。LESS组与CLS组对比，术后住院时间短、疼痛轻，术后满意度高，术中出血量、围手术期并发症与传统三孔法均无显著性差异。结论在严格选择病例、有熟练掌握腹腔镜技术的主刀医师前提下，经过10-20例学习曲线后，应用常规腹腔镜手术器械进行异位妊娠手术，并未增加手术时间，术中出血量及术后并发症与传统三孔法相似，且术后切口疼痛轻，住院时间短，腹壁美容效果好，说明经脐单孔腹腔镜治疗异位妊娠是安全可行的，值得临床推广应用。更多还原

【Abstract】 Objective: To discuss the safety and feasibility of laparoendoscopicsingle-site surgery for ectopic pregnant patients.Methods:72cases with ectopic pregnancy who accepted laparoscopicsurgery during June2010to September2012were retrospectivelyanalyzed.26cases underwent laparoendoscopic single-site surgery (LESS),inwhich22cases of tubal incision embryo-taking surgery and4cases ofperformed salpingectomy.46cases underwent conventional laparoscopicsurgery(CLS),in which38cases of tubal incision embryo-taking surgery and8cases of salpingectomy. Several indexes such as age, BMI, operation record,perioperative period complications, postoperative VAS pain score,postoperative hospital stay，satisfaction of patients were recruited to comparebetween the two groups.Results: In the beginning, the operation time was significantlyprolonged in LESS group. But after10-20cases, it was significantly reducedand no obvious difference with the conventional group. That showed shorterpostoperative hospital stay, postoperative pain and satisfaction in the LESSgroup, whereas no significant differences between the amount ofbleeding, perioperative complications.Conclusion: Laparoendoscopic single-site surgery has all the advantagesof conventional laparoscopic surgery and more minimal invasive and bettercosmetic results of abdominal wall. On the premise of strictly selectedpatients and surgeons who acquire proficiency in laparoscopic technology, it was also safety to perform laparoscopic surgery of ectopic pregnancy eventhough in the beginning of carrying out LESS with conventional laparoscopicappliances after learning curve of10-20patients. It is safety and feasibility ofLESS for ectopic pregnant patients. And it is worthy of clinical application.更多还原