腹腔镜手术治疗脐尿管囊肿疗效及安全性研究

Safety evaluation of laparoscopic treatment of urachal cyst

目的:研究腹腔镜手术治疗脐尿管囊肿的安全性。方法:选择因尿频、脐周疼痛、血尿、发热等入院治疗并确诊为脐尿管囊肿的患者43例,按照患者手术方法不同分为传统组20例,腹腔镜组23例。传统组患者行传统开腹手术治疗,腹腔镜组患者行腹腔镜下手术治疗。比较两组患者围术期相关资料,包括手术时间、出血量、住院时间、留置导尿时间;使用Spitzer生存质量评分表对两组患者术后1周的生活质量进行评分;使用本院自制的满意度评价表对两组患者的治疗满意度进行分析;比较两组患者治疗后的复发率和并发症发生率,包括:腹痛、泌尿系统感染、脐部或膀胱不适以及漏尿等。结果:腹腔镜组患者的手术时间、术中出血量、住院时间和留置导尿时间均显著低于传统组(P<0.05)。传统组与腹腔镜组在活动、日常生活、支持、精神及健康评分之间比较差异无统计学意义(P>0.05),腹腔镜组总分显著高于传统组(P<0.05)。传统组与腹腔镜组的满意度相比差异无统计学意义(P>0.05)。对患者进行为期1年的随访发现,传统组和腹腔镜组患者均未发生脐尿管囊肿的复发。两组患者术后并发症发生率经比较差异无统计学意义(P>0.05)。结论:与传统开腹手术相比,腹腔镜手术治疗脐尿管囊肿能够明显改善患者的围术期指标,提高生活质量,且治疗满意度高,术后复发率低,安全性好。

Objective To study the safety evaluation of laparoscopic treatment of urachal cyst.Methods:43 patients with urinary tract cysts for urinary frequency,umbilical pain,hematuria,and fever were selected.According to the different surgical methods,the patients were divided into the traditional group and the laparoscopic group,including 20 cases in the traditional group and 23 cases in the laparoscopic group.Patients in the traditional group underwent conventional open surgery,and patients in the laparoscopic group underwent laparoscopic surgery.The perioperative data of the two groups were compared,including the operation time,the amount of bleeding,the length of hospital stay,and the time of indwelling catheterization.The quality of life of the two groups of patients was scored 1 week after surgery using the spitzer quality of life scale.The treatment satisfaction of the two groups of patients were analyzed using our self-made satisfaction evaluation form.The postoperative recurrence rate and complication rate after treatment were compared between the two groups,including abdominal pain,urinary tract infection,umbilical or bladder discomfort,and leakage of urine.Results:Compared with the conventional group,the operation time,intraoperative blood loss,hospitalization time and indwelling catheterization time of the laparoscopic group were significantly lower than those of the laparoscopic group(P<0.05).There was no significant difference in activity,daily life,support,mental and health scores between the traditional group and the laparoscopic group(P>0.05).The total score of quality of life in the laparoscopic group was significantly higher than that in the traditional group(P<0.05).There was no significant difference between the traditional group and the laparoscopic group(P>0.05).A one-year follow-up of the patients revealed no recurrence of urachal cysts in the conventional and laparoscopic groups.There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).Conclusion Compared with traditional open surgery,laparoscopic treatment of urachal cysts can significantly improve perioperative data,improve quality of life,and have high satisfaction with treatment,low postoperative recurrence rate,good safety.