微创单孔腹腔镜治疗卵巢囊肿患者手术入路方案研究

Comparison of umbilical single hole laparoscopic and traditional three holes laparoscopic surgery in ovarian cyst

目的比较经脐单孔腹腔镜与传统三孔腹腔镜卵巢囊肿剔除术的临床效果。方法选取在该院住院拟行良性卵巢囊肿剔除手术的患者90例,随机分为对照组和观察组,每组45例患者,对照组给予传统三孔腹腔镜治疗方式,观察组给予单孔腹腔镜治疗方式,比较两组患者手术效果、术后并发症、卵巢功能指标和美观满意度。结果两组患者的手术时间、术中出血量、术后排气时间和术后住院时间的差异均无统计学意义(P>0.05),观察组患者的术后24和72 h的疼痛感均明显低于对照组,且差异具有统计学意义(P<0.05);两组患者的术后切口感染和意外肠道损伤的差异无统计学意义(P>0.05);与术前的结果相比,两组患者在术后30 d后促黄体生成素(LH)和促卵细胞激素(FSH)含量均有提升,雌二醇(E2)含量有明显地降低,且差异具有统计学意义(P<0.05);术前两组患者E2、LH和FSH的含量差异无统计学意义(P>0.05),术后两组患者E2、LH和FSH的含量差异均无统计学意义(P>0.05);观察组患者的美观总满意度明显高于对照组,且差异具有统计学意义(P<0.05)。结论单孔微创腹腔镜手术应用于剔除巢囊肿患者的治疗,在相同疗效的基础上,不仅可以有效地降低患者术后的疼痛感,还可以提升患者的美观满意度,值得临床推广。

Objective To compare the clinical effect of the umbilical single hole laparoscopic and traditional three holes laparoscopic surgery in ovarian cyst. Methods 90 patients with ovarian cyst surgery were selected, and randomly divided into observation group and control group with 45 patients in each group. The control group was given traditional three holes laparoscopic surgery, and the observation group received single hole laparoscopic surgery.Clinical effect, postoperative complications, ovarian function, aesthetic satisfaction were compared between the two groups. Results The differences of operative time, blood loss, postoperative exhaust time, postoperative hospital stay between the two groups has no statistical difference（P〈0.05）, the postoperative pain in 24 h, 72 h in the observation group were significantly lower than that in control group, with significant difference（P〈0.05）. There was no significant difference in the incidence of postoperative complications between the two groups（P〉0.05）. The contents of FSH and LH in the two groups were significantly improved, and the content of E2 was significantly decreased after postoperative 30 days, compared with the preoperative, and the difference were statistically significant（P〈0.05）.There was no significant difference in LH, FSH and E2 level in the two groups before operation（P〉0.05）, and there was no significant difference in the content of LH, FSH and E2 between the two groups（P〉0.05）. The total satisfaction of the observation group was significantly higher than the control group, and the difference was statistically significant（P〈0.05）. Conclusion Single hole laparoscopic surgery is adapted to the treatment of patients with ovarian cyst on the basis of the same effect. Not only reduced the pain, but also improved the patients＇ satisfaction degree of the incision. It is worthy of clinical promotion.