腹腔镜手术治疗妊娠中期合并盆腔包块39例临床分析

Trimester pelvic tumor clinical analysis of 39 cases of laparoscopic surgery

目的：探讨应用腹腔镜手术治疗妊娠中期合并盆腔包块的手术效果及安全性。方法回顾性分析2007年1月至2012年7月间广东医学院附属厚街医院与广东省人民医院妇科共对39例妊娠中期（孕13~22周）合并盆腔包块行腹腔镜手术的孕妇临床资料，对妊娠中期腹腔镜手术情况及妊娠结局进行分析。结果39例妊娠中期合并盆腔包块的孕妇成功接受了腹腔镜手术，其中31例行卵巢囊肿剥除术，8例患者因蒂扭转导致不可逆性坏死行患侧附件切除术。术后病理结果均为良性病变。平均手术时间68 min，平均出血量43 ml。术后平均肛门排气时间13.5 h，术后平均住院日4.2 d。除1例因为胎儿原因引产外，余均足月分娩。新生儿均无畸形。结论对妊娠中期合并盆腔包块的孕妇行腹腔镜手术具有出血少、手术时间及住院时间短、安全可行的优势，是对盆腔良性肿块的妊娠中期孕妇可供参考的手术方法。

Objective To investigate the efficacy and safety of laparoscopic surgery in secondtrimester among pregnant women(12~22 w) with pelvic mass. Method The clinical data, surgery conditionsand pregnancy outcomes of 39 pregnant women in second trimester with pelvic mass who were treated in theHoujie Hospital of Guangdong Medical College and the Guangdong General Hospital from January 2007 to July 2012 were retrospectively analyzed. Results All of thecases accepted laparoscopic surgery successfully.31 cases undergone laparoscopic oophorocystectomy and 8 cases undergone oophorectomy in involved side onaccount.of irreversible necrosis caused by torsion of the pedicle. The average operative time was 37 min, theaverage amount of bleeding was 43 ml, the average postoperative anal exhaust time was 13.5h and the averagepostoperative hospital stay were 4.2 days. Except one case of abortion because the fetus reason, the remainderwere full-term delivery, and there were no abnormal newborn. Conclusions Laparoscopic surgery for thesecond trimester among pregnant women with pelvic mass has the advantage of less bleeding, shorter operationtime, shorter hospital stay and safe operation, it's a preferred surgical method.