经脐单孔腹腔镜卵巢囊肿剥除术对卵巢囊肿患者炎症因子和卵巢储备功能的影响

Effect of transumbilical single-port laparoscopic ovarian cystectomy on inflammatory factors and ovarian reserve function in patients with ovarian cysts

目的:探讨经脐单孔腹腔镜卵巢囊肿剥除术与传统腹腔镜手术治疗卵巢囊肿的疗效及其对炎症因子、卵巢储备功能的影响。方法:回顾性分析2019年7月至2021年12月在池州市人民医院接受卵巢囊肿剥除术的患者100例,其中46例行经脐单孔腹腔镜手术(single incision laparoscopic surgery,SILS;单孔组),54例行传统腹腔镜手术(传统组)。比较2组术前及术后24 h C反应蛋白(C-reaction protein,CRP)、白细胞计数(white blood cell,WBC)和术前及术后1、3个月雌二醇(estradiol,E_(2))、卵泡刺激素(follicle-stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)及出院时美观满意度。结果:相比传统组,单孔组术中出血量减少(P<0.05),术后24 h数字疼痛评分(Numerical Rating Scale,NRS)降低(P<0.05),首次排气时间、首次下床时间、术后住院时间均提前(均P<0.05);2组手术时间、囊肿破裂发生率比较差异均无统计学意义(均P>0.05)。术后24 h,相比传统组,单孔组CRP、WBC均显著降低(均P<0.05)。术后1个月,2组E_(2)相比术前均降低(均P<0.05),FSH、LH相比术前均增高(均P<0.05),2组差异均无统计学意义(均P>0.05);术后3个月,2组E_(2)、FSH及LH相比术前均无明显变化(均P>0.05),且组间差异均无统计学意义(均P>0.05)。出院时,单孔组患者对切口美观满意度优于传统组(P<0.05)。结论:经脐单孔腹腔镜卵巢囊肿剥除术治疗卵巢囊肿相比传统腹腔镜手术更具微创优势,可减轻术后炎症应激反应,促进术后恢复,提高术后切口美观度,且不会对卵巢储备功能造成不良影响。

Objective:To investigate the efficacy of transumbilical single-port laparoscopic ovarian cystectomy compared with traditional laparoscopic surgery in the treatment of ovarian cysts and its influence on inflammatory factors and ovarian reserve function.Methods:A total of 100 patients who underwent ovarian cystectomy in Chizhou People’s Hospital from July 2019 to December 2021 were retrospectively analyzed,which include 46 cases of transumbilical single incision laparoscopic surgery(SILS)(single-port group)and 54 cases of traditional laparoscopic surgery(traditional group).C-reactive protein(CRP)and white blood cell count(WBC)were compared between the 2 groups before and 24 h after the operation.The estradiol(E_(2)),follicle-stimulating hormone(FSH),and luteinizing hormone(LH)were compared between the 2 groups 1 and 3 months after the operation.The aesthetic satisfaction of the 2 groups at discharge was also compared.Results:Compared with the traditional group,the intraoperative blood loss in the single-hole group was decreased(P<0.05),the NRS score at 24 h after the operation was decreased(P<0.05),and the first exhaust time,the first ambulation time,and the postoperative hospitalization time were all advanced(all P<0.05).There was no significant difference in operation time and incidence of cyst rupture between the 2 groups(P>0.05).At 24 h after the operation,compared with the traditional group,CRP and WBC in the single hole group were significantly decreased(both P<0.05).One month after the operation,E_(2)in the 2 groups were lower than those before the operation(P<0.05),FSH and LH were higher than those before the operation(both P<0.05),there was no difference between the 2 groups(P>0.05);3 months after the operation,there was no significant change in E_(2),FSH,and LH than those before the operation(P>0.05),and there was no difference between the 2 groups(P>0.05).At discharge,the satisfaction of patients in the single-hole group was better than that in the traditional group(P<0.05).Conclusion:Transumbilical single-port laparoscopic ovarian cystectomy has more minimally invasive advantages than traditional laparoscopic surgery in the treatment of ovarian cysts,which can reduce postoperative inflammatory stress response,promote postoperative recovery,improve postoperative incision aesthetics,and do not have adverse effects on ovarian reserve function.