二孔法与三孔法腹腔镜手术治疗卵巢成熟畸胎瘤患者的效果对比

Comparison of the Effect of Two Hole and Three Hole Laparoscopic Surgery in the Treatment of Mature Ovarian Teratoma

目的:对比探讨二孔法与三孔法腹腔镜手术治疗卵巢成熟畸胎瘤患者的临床效果。方法:选取2019年9月-2021年8月佳木斯市中心医院收治的105例卵巢成熟畸胎瘤患者为研究对象,以住院号进行随机抽签分为观察组(n=53)、对照组(n=52)。对照组以三孔法腹腔镜手术治疗,观察组以二孔法腹腔镜手术治疗。对两组患者的手术相关指标、并发症发生率、雌激素水平、卵巢储备功能、术后应激反应指标等进行统计比较。结果:观察组手术时间、术后肠道功能恢复时间、术后开始下床活动时间、住院时间均短于对照组,术中失血量少于对照组(P<0.05)。观察组并发症发生率为7.55%(4/53),低于对照组的23.07%(12/52)(P<0.05)。观察组术后的雌二醇(E_(2))、黄体生成素(LH)、卵泡刺激素(FSH)水平均低于对照组(P<0.05)。观察组术后的抗米勒管激素(AMH)、抑制素B(INHB)、窦卵泡计数(AFC)水平均高于对照组(P<0.05)。术后,观察组患者的皮质醇(Cor)、β-内啡肽(β-EP)、去甲肾上腺素(NE)水平均低于对照组(P<0.05)。结论:二孔法与三孔法腹腔镜手术均可用于卵巢成熟畸胎瘤患者的治疗,而二孔法腹腔镜手术的效果更佳,手术操作简便,术后患者恢复快,手术安全性高,术后应激反应水平低,对患者卵巢储备功能和雌激素水平影响较小,值得临床推荐。

Objective:To compare the clinical effects of two hole and three hole laparoscopic surgery in the treatment of mature ovarian teratoma.Method:A total of 105 patients with mature ovarian teratoma treated in Jiamusi Central Hospital from September 2019 to August 2021 were selected as the treatment objects.The hospitalized number was randomly divided into observation group(53 cases)and control group(52 cases).The control group was treated with three hole laparoscopic surgery,and the observation group was treated with two hole laparoscopic surgery.The operation related indexes,complication rate,estrogen level,ovarian reserve function and postoperative stress response indexes of the two groups were statistically compared.Result:The operation time,postoperative intestinal function recovery time,postoperative start time out of bed,hospital stay of the observation group were shorter than those of the control group,and the intraoperative blood loss was less than that of the control group(P<0.05).The incidence of complications in the observation group was 7.55%(4/53),which was lower than 23.07%(12/52)in the control group(P<0.05).The levels of estradiol(E_(2)),luteinizing hormone(LH)and follicle stimulating hormone(FSH)in the observation group were lower than those in the control group(P<0.05).The levels of anti mullerian hormone(AMH),inhibin B(INHB)and antral follicle count(AFC)in the observation group were higher than those in the control group(P<0.05).After operation,the levels of cortisol(Cor),β-endorphin(β-EP)and norepinephrine(NE)in observation group were lower than those in the control group(P<0.05).Conclusion:Two hole and three hole laparoscopic surgery can be used in the treatment of mature ovarian teratoma,while the two hole laparoscopic surgery has the better effect,simple operation,quick recovery after operation,high safety,low postoperative stress response,little influence on ovarian reserve function and estrogen level,and is worthy of clinical recommendation.