三种手术方法治疗卵巢囊肿的临床分析

Clinical analysis of three operation methods for the treatment of ovarian cysts

目的:通过观察三种手术治疗卵巢囊肿的临床疗效,评价悬吊式腹腔镜手术治疗卵巢囊肿的临床应用价值。方法:回顾分析2011年1月至2014年3月手术治疗的120例卵巢囊肿患者的临床资料,其中行悬吊式腹腔镜手术40例(悬吊组),气腹式腹腔镜手术40例(气腹组),开腹手术40例(开腹组)。对比3组患者手术时间、术中出血量、术后疼痛、肛门排气时间、住院时间、住院费用及患者术后卵巢排卵、月经情况。结果:腹腔镜组较开腹组术中出血量少,切口疼痛评分低,住院时间短;悬吊组较气腹组手术时间短,非切口疼痛发生率低,术后不良反应少,手术总费用低(P<0.05)。结论:悬吊式腹腔镜卵巢囊肿手术具有切口美观、患者创伤小、康复快等优点,且术后不良反应少,手术时间短,手术相关费用低,提升了腹腔镜手术的可操作性,使卵巢功能得到很好的保护,拓宽了腹腔镜手术的应用范围,具有较高的临床应用价值,年轻有生育要求的女性患者尤为适用,利于微创技术在基层医院的普及推广。

Objective：To evaluate the clinical application value of suspensory laparoscopic surgery in the treatment of ovarian cysts by observing three different kinds of operative treatment methods for ovarian cysts. Methods：The clinical data of 120 patients who had received operative treatment for ovarian cysts between Jan. 2011 and Mar. 2014 were retrospectively analyzed. Of them,40 patients received suspensory laparoscopic surgery, 40 underwent pneumoperitoneum laparoscopic surgery and 40 laparotomy. Comparison was made on length of operation,intraoperative amount of bleeding, postoperative pain, time of anal aerofluxus, hospital stay, hospitalization expenses, postoperative ovulation and menstruation condition of three groups. Results： Compared with open surgery group, laparoscopic group had less intraoperative bleeding,lower postoperative incision pain score and shorter hospital stay. Compared with pneumoperitone- um group, gasless laparoscopic group had shorter operation time ,lower incidence of non-incision pain, fewer side effects and less opera- tion cost （ P 〈 0.05 ）. Conclusions： Gasless laparoscopy for ovarian cysts inherits the advantages of minimally invasive surgery in the aspects of incision cosmetic standards, little trauma and rapid recovery. Besides, with less postoperative side effect and operation time, the surgical costs are decreased and maneuverability of laparoscopic surgery is improved, which is helpful to greatly protect ovarian func- tion and broaden the application scope of laparoscopy. With greater clinical value, it is especially suitable for those young women who have their demands for fertility, and it is also beneficial for a wide spread of the minimally invasive technique in primary hospitals.