常规器械经脐单孔三通道法腹腔镜与传统腹腔镜下全子宫切除术的对比研究

Comparison of the effect between laparoscopic surgery through conventional umbilical single-hole three-channel method and traditional laparoscopic in total hysterectomy

目的:比较常规器械经脐单孔三通道法腹腔镜与传统腹腔镜全子宫切除术临床应用效果对比。方法:回顾分析2018年3月~2019年11月在该院就诊有全子宫切除指征患者,按手术方式不同,分为常规器械经脐单孔三通道法腹腔镜和传统腹腔镜组。其中行传统腹腔镜下全子宫切除术共30例为对照组,常规器械经脐单孔三通道法腹腔镜全子宫切除术30例为观察组。比较两组患者术中出血量、手术时间、气腹介质使用总量、术后肛门排气时间、术后疼痛评分、切口美容满意度、术后住院时间、手术耗材费用等方面的差异。结果:观察组的手术时间、出血量、手术耗材费用与对照组比较无明显差异;观察组术后肛门排气时间、术后住院时间、术后疼痛评分低于对照组;观察组术后切口美容满意度评分高于对照组。结论:常规器械经脐单孔三通道法腹腔镜下全子宫切除术能满足患者的美容心理需求,降低患者术后疼痛,缩短术后肛门排气时间、缩短住院时间,并不增加患者手术时间、术中出血、手术耗材费用,手术安全、可行,符合卫生经济学成本,可在妇科手术领域中推广。

Objective To compare the clinical application effect of conventional instruments through umbilical single-hole three-channel laparoscopy and traditional laparoscopic total hysterectomy.Methods Patients with indications for total hysterectomy in the hospital from March 2018 to November 2019 were divided into conventional equipment through the umbilical single-hole three-channel laparoscopic group and traditional laparoscopic group.Among them,30 cases underwent laparoscopic total hysterectomy in the traditional group were set as the control group,and 30 cases underwent laparoscopic total hysterectomy through the umbilical single-hole three-channel method in the conventional group as the observation group.The intraoperative blood loss,operation time,total pneumoperitoneum media usage,postoperative anal exhaust time,postoperative pain score,incision beauty satisfaction,postoperative hospital stay,and surgical consumables costs were compared between the two groups.Results The operation time,bleeding volume,and surgical consumables costs of the observation group were not statistically significant compared with the control group;the postoperative anal exhaust time,postoperative hospital stay,and postoperative pain score of the observation group were lower than those of the control group,Postoperative incision beauty satisfaction score was higher than the control group.Conclusion Conventional instruments through the umbilical single-hole three-channel laparoscopic total hysterectomy can meet the patient’s cosmetic psychological needs,reduce the patient’s postoperative pain,shorten the postoperative anal exhaust time,shorten the hospital stay,and not increase the patient’s surgical time 2.The cost of intraoperative bleeding and surgical consumables.The operation is safe and feasible.It meets the cost of health economics and can be promoted in the field of gynecological surgery.