三种手术方式治疗卵巢囊肿的效果比较

Comparison of three kinds of operation mode for treatment of ovarian cyst

目的：比较三种手术方式治疗卵巢囊肿的效果。方法138例卵巢囊肿患者按照数字表法随机分为三组，A组46例采用开腹手术治疗，B组46例采用阴式手术治疗，C组46例采用腹腔镜手术治疗。观察三组手术情况（手术时间、术中出血量、首次排气时间、住院时间）、并发症（感染、出血、围绝经期改变），术后随访1年观察其复发率。结果 A组46例均顺利完成手术，B、C两组各有1例患者由于粘连严重而中转进行开腹手术。A组手术时间、术中出血量、首次排气时间、住院时间分别为（76．8±6．9）min、（69．1±6．4）mL、（18．6±3．6）h、（9．6±2．3）d，B组分别为（41．3±4．5）min、（33．6±4．1）mL、（10．1±2．5）h、（5．6±1．4）d，C组分别为（58．3±5．6）min、（35．6±4．9）mL、（16．8）h、（6．1±1．7）d，B、C两组的手术时间、术中出血量、住院时间均明显少于A组（t＝4．306、5．172、3．012，3．926、3．776、2．168，均P＜0．05）；B组首次排气时间明显短于A、C两组（t＝3．014、2．446，均P＜0．05）；B组手术时间明显短于C组（t＝2．748，P＜0．05）。A、B、C三组术后并发症发生率分别为39．1％、11．1％、15．6％，B、C两组的并发症发生率明显低于A组（χ^2＝9.82、8.64，P＜0．01）。术后随访1年，B组复发率为11．1％，明显高于A组（2．2％）、C 组（2．2％）（χ^2＝6.72、6.72，P＜0．01）。结论阴式手术和腹腔镜手术治疗卵巢囊肿创伤小，但粘连重者应行开腹治疗，进行个体化治疗。

Objective To compare the effectiveness of the three operation mode in treatment of ovarian cyst. Methods According to the digital table,138 patients with ovarian cyst were divided into three groups,the group A （n=46 cases）were operated through open operation,group B （n =46 cases）were operated through transvaginal operation,group C（n=46 cases）were operated through laparoscopic operation.The three groups were observed the situation of operation （operation time,bleeding volume,the first exhaust time,hospitalizationtime ）,complications （infection,hemorrhage,perimenopausal changes ）,postoperative follow -up for 1 years.The recurrence rate was observed.Results Group A of 46 patients were successfully completed surgery,B,C groups of 1 patients was con-versed to laparotomy due to severe adhesion.B,C groups in the operation time,amount of bleeding during the opera-tion,the time of hospitalization were significantly less than that of group A （t=4.306,5.172,3.012,3.926,3.776, 2.168,P〈0.05,P〈0.01）.B group was significantly less than those of A,C group in the first exhaust time （t=3.014,2.446,all P〈0.05）.In the operation time of group B was obviously less than that of group C （t=2.748,P〈0.05）.A,B,C three groups of postoperative complication rates were 39.1%,11.1%,15.6% respectively;the incidence of complications of B,C groups was lower than that in A group （χ^2 =9.82,8.64,all P〈0.01 ）.After 1years follow-up,the recurrence rate in group B was significantly higher than that of A and C groups （χ^2 =6.72, 6.72,all P〈0.01）.Conclusion Treatment of ovarian cyst vaginal surgery and laparoscopic surgery wound is small, but the person that weigh should be performed open adhesion treatment,individualized treatment.