单孔腹腔镜治疗子宫肌瘤的临床效果研究

Clinical effect of single-port laparoscopy in the treatment of uterine fibroids

目的 探讨单孔腹腔镜应用于子宫肌瘤治疗中的临床效果。方法 选取2021年5月至2022年10月揭阳市慈云医院收治的子宫肌瘤患者80例,随机分为对照组(多孔腹腔镜子宫肌瘤剔除术组)与观察组(单孔腹腔镜子宫肌瘤剔除术组)各40例。比较2组患者术前一般临床资料、术中相关指标(最大肌瘤直径、肌瘤剔除个数、术中出血量和手术时间、术后相关指标[血红蛋白下降值、肛门排气时间、术后感染率和术后24 h与3 d视觉模拟评分(VAS)]及手术与住院费用。比较2组患者术后3 d、1个月、3个月切口满意度瘢痕评估量表(POSAS)评分和术后并发症发生率。结果 2组术中平均最大肌瘤直径及平均肌瘤剔除个数比较,差异无统计学意义(P>0.05);观察组术中出血量、手术时间低于对照组(P<0.05)。2组血红蛋白水平下降值比较,差异无统计学意义(P>0.05);观察组肛门排气时间、术后感染率、术后24 h与3 d VAS评分、手术费用、住院总费用均低于对照组(P<0.05)。观察组术后3 d、1个月及3个月POSAS评分和术后并发症发生率均低于对照组(P<0.05)。结论 子宫肌瘤患者以经脐单孔腹腔镜子宫肌瘤剔除术治疗的效果明显,能缩减手术时间,降低术中出血量,缩短患者术后肛门排气时间,减低术后感染风险,降低手术费用及住院费用,提升患者对手术切口的满意度,避免术后并发症发生,值得临床推广。

Objective To investigate the efficacy of single⁃port laparoscopy in the treatment of uterine fibroids.Methods A total of 80 patients with uterine fibroids admitted to Jieyang Ciyun Hospital from May 2021 to October 2022 were randomly divided into a control group(multi⁃port laparoscopic myomectomy group)and an observation group(single⁃port laparoscopic myomectomy group),with 40 cases in each group.General clinical data,intraoperative indicators(maximum myoma diameter,number of resected myomas,intraoperative blood loss and operation time),postoperative indicators[hemoglobin decline,anal exhaust time,postoperative infection rate and visual analogue scale(VAS)score at 24 h and 3 d after operation],and medical costs were compared between the two groups.The patient and observer scar assessment scale(POSAS)score at 3 days,1 month and 3 months after operation and the incidence of postoperative complications were also compared between the two groups.Results There was no significant difference in the average maximum myoma diameter or the number of number of resected myomas between the two groups(P>0.05).The intraoperative blood loss and operation time in the observation group were significantly less than those in the control group(P<0.05).There was no significant difference in the decrease of hemoglobin concentration between the two groups(P>0.05).The anal exhaust time,postoperative infection rate,VAS scores 24 h and 3d after operation,surgery cost and total hospitalization cost of the observation group were significantly lower than those of the control group(P<0.05).The POSAS scores at 3 days,1 month and 3 months after operation and the incidence of postoperative complications in the observation group were significantly lower than those in the control group(P<0.05).Conclusion Single⁃port transumbilical laparoscopic myomectomy can reduce operation time,intraoperative blood loss,postoperative anal exhaust time,postoperative infection risk,and medical costs,improve patients’satisfaction with the surgical incision,and avoid postoperative complications in the treatment of uterine fibroids.