宫腔镜辅助经阴道切除与腹腔镜手术治疗卵巢良性肿瘤观察

Comparative Analysis in the Treatment of Benign Ovarian Tumor by Hysteroscopy-assisted Transvaginal Hysterectomy and Laparoscopic Operation

目的系统评价宫腔镜辅助经阴道切除术与腹腔镜手术治疗卵巢良性肿瘤的临床效果,为临床治疗提供更优方案。方法 HTK选择2014年2月至2016年4月我院收治的卵巢良性肿瘤患者62例,按随机数字表法随机分为宫腔镜组和腹腔镜组,其中宫腔镜组30例行宫腔镜辅助经阴道切除术,腹腔镜组32例行腹腔镜手术切除。对比两组手术时间、出血量、肠道功能恢复时间、住院时间、疼痛分级、术后并发症发病率以及住院费用等指标,系统评价两种治疗方式的临床效果。结果宫腔镜组手术时间较腹腔镜组短、术后肠道功能恢复更快、住院费用更低,组间差异有统计学差异(P<0.05),但两组手术出血量、住院时间无统计学差异(P>0.05)。宫腔镜组术后恢复状况良好,仅出现1例非特异性阴道炎,并发症发生率为3.33%,创面无出血;腹腔镜组术后出现并发症9例,主要为咽喉肿痛、皮下气肿以及腹壁切口红肿等,并发症发生率为28.13%,经抗炎局部换药处理后均痊愈。两组疼痛分级和并发症发生率差异有统计学意义(P<0.05)。结论宫腔镜辅助经阴道切除术治疗卵巢良性肿瘤较腹腔镜手术创伤更小、术后肠道功能恢复更快,并发症更少,疼痛程度更轻且更具经济性,是治疗卵巢良性肿瘤的更佳选择。

Objective To evaluate the clinical effects of hysteroscopy-assisted transvaginal hysterectomy and laparoscopic opera-tion on benign ovarian tumor, and to provide a better solution for clinical treatment. Methods 62 cases with benign ovarian tumor ad-mitted in our hospital from February 2014 to April 2016 were selected. The patients were randomly divided into hysteroscope group and laparoscope group according to the random number table. 30 cases in hysteroscope group underwent hysteroscopy-assisted transvaginal hysterectomy, while 32 cases of laparoscope group were given laparoscopic operation. The indicators of time, bleeding amount, recov-ery time of bowel function, length of hospital stay, pain score, postoperative complications and hospitalization expenses of the two groups were analyzed to evaluate the their clinical effects. Results Compared with laparoscope group, hysteroscopy group had a shor-ter operation time, sooner recovery of intestinal function, and less cost of hospitalization. The differences were statistically different （ P〈0. 05）. There were no significant differences in the bleeding amount, hospitalization time and other indicators （P〉0. 05）. The post-operative recovery of hysteroscope group was in good condition, with only 1 case of nonspecific vaginitis. The incidence rate was 3. 33%, and the wound didn’t bleeding. There were 9 cases with complications mainly as sore throats, subcutaneous emphysema, and abdominal incision inflammation, etc. in laparoscope group. The incidence rate was 28. 13%, and all recovered after local switching anti-inflammatory treatment. There were significant differences in pain score and incidence of complications between the two groups （ P〈0. 05）. Conclusion Compared with laparoscopic surgery, hysteroscopy-assisted transvaginal hysterectomy in the treatment of be-nign ovarian tumor has less surgical trauma, faster recovery of intestinal function, fewer complications, lower pain score, more econo-my, and is a better choice for the treatment of benign ovarian tumor.