不同手术方式对中期妊娠卵巢肿瘤患者的应用效果

Effect of Different Surgical Methods on Patients with Ovarian Tumor in Second Trimester Pregnancy

目的探讨不同手术方式对中期妊娠卵巢肿瘤患者的应用效果。方法收集60例中期妊娠卵巢肿瘤患者的临床资料,根据治疗方式不同分组,行腹腔镜手术的32例作为腹腔镜组,行开腹手术的28例为开腹组。统计2组手术时间、术后排气时间、术中出血量、术后住院天数、切口感染发生情况,比较2组术后24 h、48 h切口疼痛程度(VAS评分)、妊娠结局、新生儿出生体重、出生后1 min、5 min Apgar评分、出生后6个月Gesell评分。结果与开腹组比较,腹腔镜组手术时间、术后排气时间、术后住院天数均较短,术中出血量较少(P<0.05)。2组术后均未发生切口感染。腹腔镜组术后24 h、术后48 h术后切口VAS评分低于开腹组(P<0.05)。2组流产率、分娩孕周、新生儿出生体重、出生后1 min、5 min Apgar评分比较,差异无统计学意义(P>0.05)。2组新生儿出生后6个月Gesell评分在适应性、大运动、精细动作、语言、个人-社交方面比较,差异无统计学意义(P>0.05)。结论腹腔镜手术治疗中期妊娠卵巢肿瘤安全可行,具有良好妊娠结局,对新生儿发育无影响,与开腹手术相比,优势在于手术时间短、术中出血量少、术后恢复快。

Objective To explore the application effect of different surgical methods in the second trimester of ovarian tumors.Methods The clinical data of 60 patients with ovarian tumors in the second trimester were collected.According to different treatment methods,32 cases underwent laparoscopic surgery were classified as laparoscopic group,and 28 cases underwent open surgery were classified as laparotomy group.The operation time,postoperative exhaust time,intraoperative blood loss,postoperative hospitalization days,and the incidence of incision infection were counted in the 2 groups.Incision pain degree(VAS score),pregnancy outcome,neonatal birth weight,Apgar score 1 min and 5 min after birth,Gesell score 6 months after birth were compared between the 2 groups.Results Compared with the laparotomy group,the operation time,postoperative exhaust time and postoperative hospitalization days were shorter in the laparoscopic group,and the amount of intraoperative blood loss was less(P<0.05).Incision infection did not occur in both groups.The VAS scores of laparoscopic incision at 24 h and 48 h were lower than those of laparotomy group(P<0.05).There was no significant difference in abortion rate,gestational week,neonatal birth weight and Apgar score 1 min and 5 min after birth between the 2 groups(P>0.05).At 6 months after birth,there were no significant differences in the Gesell scores of the 2 groups in adaptability,gross motor,fine motor,language and personal-social aspects(P>0.05).Conclusion Laparoscopic surgery in the treatment of ovarian tumors in the second trimester is safe and feasible,has a good pregnancy outcome,and has no impact on neonatal development.Compared with open surgery,the advantages are short operation time,less intraoperative blood loss and faster postoperative recovery.