欧阳秋 宋淑红 习智贞

[摘要]目的 探討单孔腹腔镜在输卵管妊娠患者中的应用效果。方法 选取2019年4～11月吉水县人民医院收治的60例输卵管妊娠患者作为研究对象，按照随机数字表法将其分为对照组和研究组，每组各30例。对照组采用三孔腹腔镜手术，研究组采用单孔腹腔镜手术。比较两组患者的手术时间、术中出血量、排气时间、住院时间、切口疼痛、总满意度与临床疗效。结果 研究组患者的手术时间长于对照组，住院时间短于对照组，差异有统计学意义（P<0.05）。术前，两组患者的视觉模拟量表（VAS）评分比较，差异无统计学意义（P>0.05）;术后1、3 d，两组患者的VAS评分均低于术前，且研究组患者的VAS评分低于对照组，差异有统计学意义（P<0.05）;研究组患者的治疗总满意度为93.33%，高于对照组的70.00%，差异有统计学意义（P<0.05）;研究组患者的治疗总有效率为96.66%，高于对照组的80.00%，差异有统计学意义（P<0.05）。结论 在输卵管妊娠患者的临床治疗中，采取单孔腹腔镜手术，可以有效减轻患者的疼痛感，提高临床治疗的满意度，缩短患者的住院时间，让患者尽早康复，具有较高的临床应用价值。

[关键词]输卵管妊娠;单孔腹腔镜;三腹腔镜;切口疼痛;总满意度

[中图分类号] R714          [文献标识码] A          [文章编号] 1674-4721（2020）8（c）-0141-04

[Abstract] Objective To explore the application effect of single-hole laparoscopy in patients with tubal pregnancy. Methods A total of 60 patients with tubal pregnancy who were treated in People′s Hospital of Jishui County from April to November  2019 were selected as subjects and divided into two groups according to the random number table method， 30 cases in each group. The control group underwent three-hole laparoscopy， and the study group underwent single-hole laparoscopy. The operation time， intraoperative blood loss， exhaust time， length of hospital stay， incision pain， satisfaction and treatment efficacy were compared between the two groups of patients. Results The operation time in the study group was longer than that in the control group， and the hospital stay was shorter than that in the control group， the differences were statistically significant （P<0.05）. Comparison of preoperative visual analogue scale （VAS） scores between the two groups showed no statistically significant difference （P>0.05）. At 1 and 3 days after the operation， the VAS scores of the two groups were lower than those of the two groups， and the VAS scores of study group were lower than that in the control group， and the differences were statistically significant （P<0.05）. The total satisfaction of the study group was 93.33%， higher than that in the control group of 70.00%， the difference was statistically significant （P<0.05）; the total effective rate of treatment in the study group was 96.66%， which was higher than that in the control group of 80.00%， the difference was statistically significant （P<0.05）. There were no significant differences in intraoperative blood loss and exhaust time between the two groups （P>0.05）. Conclusion In the clinical treatment of tubal pregnancy patients， single-hole laparoscopic surgery can effectively reduce the patients′ pain， improve the satisfaction of clinical treatment， further shorten the length of hospitalization of the patient， and allow the patients to recover as soon as possible. It has high clinical application value.

[Key words] Tubal pregnancy; Single-hole laparoscope; Three- hole laparoscope; Incision pain; Total satisfaction

输卵管妊娠是指受精卵着床于输卵管的异位妊娠，以停经、阴道流血、腹痛为主要症状，如不及时治疗，会导致患者昏厥、休克或不孕，危害患者健康[1]。目前，主要通过切除输卵管或输卵管开窗取胚术来治疗该疾病。腹腔镜手术具有微创、疼痛轻、恢复快的优势，因此，输卵管妊娠手术多通过腹腔镜完成操作。以往多采用传统三孔腹腔镜手术治疗输卵管妊娠，但随着人们的审美观念的提高，最大程度地减少手术创伤已成为外科医生的追求。经脐单孔腹腔镜手术是在传统三孔腹腔镜基础上进行改进，通过脐部单切口多通道设备完成手术，从而达到无斑痕的美容效果[2]。为了进一步研究单孔腹腔镜在输卵管妊娠患者中的应用效果，本研究选取吉水县人民医院收治的60例输卵管妊娠患者作为研究对象，旨在为临床输卵管妊娠治疗提供新方法，现报道如下。……