腹腔镜下卵巢良性肿瘤剥除术95例临床分析

Laparoscopic ovarian cystectomy 96 patients with benign clinical experience

目的探讨腹腔镜下卵巢良性肿瘤剥除术的安全性、优越性。方法对95例（腹腔镜组）卵巢良性病变行腹腔镜下卵巢病变剥除术加电凝修复术或缝合止血法，并与以往开放手术治疗的卵巢良性肿瘤患者100例（开放手术组）相比较，观察两组手术效果及手术并发症等。结果腹腔镜组手术时间（40．5±5．3）min显著短于对照组（60．7±-6．8）rain（t=-14．815，P=0．000）；术中出血量（55．1±9．8）ml显著少于对照组（90．0±15．0）ml（t=-18．275，P=0．001）；术后肛门排气时间（13．5±8．3）h显著短于对照组（24．5±9．6）h（t=-4．351，P=0．000）；术后平均住院时间（3．5±1．3）d显著短于对照组（5．0±2．0）d（t=-2．158，P=0．000）；术后病率与对照组差异无统计学意义（0例，5例，P=0．053）；术后疼痛明显轻于对照组（X2=8．525，P=0．002）。腹腔镜组中转开放手术2例，术后均不需用镇痛药，术后12h后拔除导尿管开始进食和下床活动，术后出现肩部酸痛感2例；开腹手术组术后均需用镇痛药、术后24h后拔除导尿管开始进食和下床活动，腹部切口脂肪液化而延期愈合4例。两组均无脏器损伤、术后出血及化学性腹膜炎。结论腹腔镜卵巢良性肿瘤剥除术具有安全、术中出血少、恢复快、发症少等特点。

Objective To evaluate the laparoscopic ovarian cystectomy of benign lesions of security, superi- ority. Methods Laparoscopic ovarian cystectomy of benign lesions of security, superiority. Results The operation time of laparoscopic group （40.5 ± 5.3 ） min, significantly shorter than the control group （ 60.7 ± 6.8 ） min （ t = -14. 815,P =0. 000） ; Bleeding （55.1 ± 9.8）ml was significantly less than that in the control group （90.0 ± 15.0） ml （ t = - 18. 275, P = 0. 001 ） ; Anus exhaust time （ 13.5 ~ 8.3 ） hour was significantly shorter than that in con- trol group （24.5 ± 9.6 ）hour （t = -4. 351, P = 0. 000 ）. The average postoperative hospital stay was （3.5 ± 1.3 ） days was significantly shorter than that in control group （ 5 ± 2 ） days （ t = - 2. 158, P = 0.000 ） ; Postoperative morbidity was not statistically different from controls （ t = 0,5 ,P = 0.053 ）. Postoperative pain was significantly lower than that in control group （ X2 = 8. 525,P = 0.002 ）. Conversion to open operation in laparoseopic group ： 2 cases, post- operative analgesic drugs were not needed, the postoperative 12h after catheter removal started eating and ambulation, postoperative shoulder pain in 2 cases ; open operation group after all need to use analgesics, postoperative 24h after catheter removal started eating and ambulation, abdominal incision fat liquefaction and delayed healing in 4 cases. The two groups had no visceral injury, postoperative bleeding, and chemical peritonitis. Conclusion Laparoscopy in the treatment of benign ovarian tumor is safe, less bleeding, rapid recovery, fewer complications and other characteristics.