经脐单孔腹腔镜在子宫肌瘤剔除术中的应用价值分析

Clinical application of transumbilical single-port laparoscopy in hysteromyomectomy

目的分析经脐单孔腹腔镜在子宫肌瘤剔除术中的应用价值。方法98例接受子宫肌瘤剔除术治疗的子宫肌瘤患者,按照其接受术式差异分为观察组和对照组,每组49例。观察组接受经脐单孔腹腔镜子宫肌瘤剔除术,对照组接受常规多孔腹腔镜子宫肌瘤剔除术。比较两组患者手术指标(手术时间、术后排气时间、术中出血量、住院时间),术前及术后炎症因子[白细胞介素-6(IL-6)、白细胞介素-2(IL-2)]水平,术前及术后不同时间(术后24、48、72 h)视觉模拟评分法(VAS)评分,术后并发症(切口出血、切口感染、粘连型肠梗阻)发生率。结果观察组患者的手术时间(69.23±5.16)min长于对照组的(56.05±4.19)min,术后排气时间(19.62±6.35)h、住院时间(4.15±1.21)d短于对照组的(36.51±4.18)h、(5.63±0.89)d,术中出血量(102.13±20.15)ml少于对照组的(135.51±16.98)ml(P<0.05)。术后3 d,观察组患者IL-6、IL-2水平分别为(3.26±0.56)pg/ml、(26.53±6.23)ng/ml,低于对照组的(5.13±0.81)pg/ml、(36.59±5.18)ng/ml(P<0.05)。术后24、48 h,观察组VAS评分分别为(3.51±0.21)、(2.01±0.15)分,低于对照组的(4.36±0.29)、(2.36±0.21)分(P<0.05);术后72 h,两组患者VAS评分比较差异无显著性(P>0.05)。观察组患者并发症发生率为2.04%(1/49),与对照组患者的8.16%(4/49)比较差异无显著性(P>0.05)。结论对子宫肌瘤患者使用经脐单孔腹腔镜进行子宫肌瘤剔除术价值值得肯定,有助于缩短患者的住院时间和排气时间,缓解患者术后炎症反应,降低患者的术后疼痛度,且并发症发生率较低,具有一定的临床推广应用价值。

Objective To analyze the application value of transumbilical single-port laparoscopy in hysteromyomectomy.Methods 98 patients who received hysteromyomectomy were divided into an observation group and a control group according to the differences in their surgical procedures,each with 49 cases.The observation group received hysteromyomectomy via transumbilical single-port laparoscopy,and the control group received hysteromyomectomy via conventional multi-port laparoscopy.Patients in both groups were compared in terms of surgical indicators(operation time,postoperative exhaust time,intraoperative bleeding volume,hospital stay),preoperative and postoperative inflammatory factors[interleukin-6(IL-6),interleukin-2(IL-2)]levels,visual analogue scale(VAS)score preoperatively and at 24,48,and 72 h postoperatively,and postoperative complications(incision bleeding,incisions infection,adhesive intestinal obstruction).Results The observation group had longer operation time of(69.23±5.16)min than(56.05±4.19)min in the control group;the observation group had postoperative exhaust time of(19.62±6.35)h and hospital stay of(4.15±1.21)d,which were shorter than(36.51±4.18)h and(5.63±0.89)d in the control group;the observation group had less intraoperative bleeding volume of(102.13±20.15)ml than(135.51±16.98)ml in the control group(P<0.05).At 3 d postoperatively,the levels of IL-6 and IL-2 in the observation group were(3.26±0.56)pg/ml and(26.53±6.23)ng/ml,which were lower than(5.13±0.81)pg/ml and(36.59±5.18)ng/ml in the control group(P<0.05).At 24 and 48 h postoperatively,VAS scores of the observation group were(3.51±0.21)and(2.01±0.15)points,which were lower than(4.36±0.29)and(2.36±0.21)points of the control group(P<0.05).At 72 h postoperatively,there was no significant difference in VAS scores between the two groups(P>0.05).The incidence of complications in the observation group was 2.04%(1/49),which had no significant difference compared with 8.16%(4/49)in the control group(P>0.05).Conclusion The value of transumbilical single-port laparoscopy for hysteromyomectomy is certain,which can help shorten the hospital stay and exhaust time of patients,relieve postoperative inflammatory response of patients,reduce postoperative pain of patients,and the incidence of complications is lower,which has certain clinical application value.