卵巢囊肿剔除术在单孔腹腔镜与传统腹腔镜下的治疗效果分析

Analysis on curative effects of ovarian cystectomy under single-port laparoscope and conventional laparoscope

目的探讨卵巢囊肿剔除术在单孔腹腔镜与传统腹腔镜下的治疗效果。方法回顾性分析徐州市中心医院2016年1月-2017年9月收治的154例卵巢囊肿患者临床资料,纳入80例卵巢囊肿患者,根据卵巢囊肿剔除术治疗方法的不同分为对照组和观察组,其中对照组38例患者接受传统腹腔镜下卵巢囊肿剔除术治疗,观察组42例患者接受单孔腹腔镜下卵巢囊肿剔除术治疗。比较两组患者临床指标、雌激素变化情况、T细胞亚群水平及并发症发生情况。结果观察组患者平均手术时间、平均术中出血量多于对照组,术后住院时间少于对照组,两组手术时间、术中出血量及术后住院时间比较,差异无统计学意义(P>0.05)。术前两组患者卵泡刺激素(FSH)、雌二醇(E_2)水平比较,差异无统计学意义(P>0.05),治疗后观察组患者FSH、E_2水平高于对照组,两组比较差异无统计学意义(P>0.05)。治疗前两组患者CD_4^+、CD_8^+及CD_4^+/CD_8^+水平比较差异无统计学意义(P>0.05)。治疗后观察组患者CD_4^+、CD_8^+及CD_4^+/CD_8^+水平显著高于对照组,差异有统计学意义(P<0.05)。观察组患者并发症发生率低于对照组,两组并发症发生率比较差异无统计学意义(P>0.05)。术后1 d两组患者疼痛评分比较,差异无统计学意义(P>0.05),术后3 d观察组患者术后疼痛评分低于对照组,差异有统计学意义(P<0.05)。观察组患者术后切口满意度显著高于对照组,差异有统计学意义(P<0.05)。结论单孔腹腔镜下卵巢囊肿剔除术较传统腹腔镜下手术更能减少患者术后并发症,提高细胞免疫力,明显降低患者术后疼痛感,提高患者术后切口满意度,值得推荐使用。

Objective To explore the curative effects of ovarian cystectomy under single-port laparoscope and conventional laparoscope. Methods The clinical data of 154 patients with ovarian cysts treated in Xuzhou Central Hospital from January 2016 to September2017 was analyzed retrospectively,then 80 patients were enrolled in this study. According to treatment method of ovarian cystectomy,80 patients were divided into control group and observation group,38 patients in control group were treated by ovarian cystectomy under conventional laparoscope,and 42 patients in observation group were treated by ovarian cystectomy under single-port laparoscope. The clinical indicators,changes of estrogen levels,levels of T lymphcyte subgroups,incidence rates of complications in the two groups were compared. Results The mean operation time and mean amount of intraoperative hemorrhage in observation group were higher than those in control group,the hospitalization time after operation in observation group was shorter than that in control group,but there was no statistically significant difference in operation time,amount of intraoperative hemorrhage,and hospitalization time after operation between the two groups（ P〈0. 05）. Before operation,there was no statistically significant difference in the levels of follicle-stimulating hormone（ FSH） and estradiol（ E2） between the two groups（ P〈0. 05）. After treatment,the levels of FSH and E2 in observation group were higher than those in control group,but there was no statistically significant difference between the two groups（ P〈0. 05）. Before operation,there was no statistically significant difference in the levels of CD4＋,CD8＋,and CD4＋/CD8＋between the two groups（ P〈0. 05）. After treatment,the levels of CD4＋,CD8＋,and CD4＋/CD8＋in observation group were statistically significantly higher than those in control group（ P〈0. 05）. The incidence rate of complications in observation group was lower than that in control group,but there was no statistically significant difference between the two groups（ P〈0. 05）. At one day after treatment,there was no statistically significant difference in pain score between the two groups（ P〈0. 05）. At three days after treatment,pain score in observation group was statistically significantly lower than that in control group（ P〈0. 05）. The satisfaction rate of postoperative incision in observation group was statistically significantly higher than that in control group（ P〈0. 05）. Conclusion Compared with ovarian cystectomy under conventional laparoscope,ovarian cystectomy under single-port laparoscope can reduce postoperative complications,improve cell immunity,significantly reduce postoperative pain,and increase satisfaction rate of postoperative incision,which is worthy of recommendation and application.