单孔腹腔镜对卵巢成熟性囊性畸胎瘤患者临床结局的影响  

Influence of laparoendoscopic single-site surgery on clinical outcomes of patients with ovarian mature cystic teratoma

作　　者：李小雪[1] 杨新园[2] 

机构地区：[1]安康市中心医院妇科,陕西安康725000 [2]西安交通大学第一附属医院妇科,陕西西安710061

出　　处：《中国妇幼健康研究》2017年第1期72-74,共3页Chinese Journal of Woman and Child Health Research

基　　金：国家自然科学基金资助项目(编号30801238)

摘　　要：目的评估单孔腹腔镜对卵巢成熟性囊性畸胎瘤患者术中和术后临床结局的影响,并通过与传统腹腔镜手术相比较,探讨其临床应用价值。方法回顾性分析西安交通大学第一附属医院妇产科2010年3月至2014年5月诊断的205例卵巢成熟性囊性畸胎瘤患者的临床资料,其中83例行单孔腹腔镜术,122例行传统腹腔镜术,比较两组患者术中和术后的临床结局。结果单孔组患者术后1d出院所占比例显著高于常规组(P=0.02<0.05),两组肿瘤大小、肿瘤部位、附件手术类型、手术时间、失血量、输血需求、Hb水平、术后住院时间、术后并发症均无显著性差异(t/χ2为值0.35~1.37,均P>0.05)。单孔组在术后8h、16h和32h疼痛评分均显著低于常规组(t值分别为1.66、1.64、3.66,均P<0.05),两组患者术后术后24h、40h疼痛评分均无显著性差异(t值分别为1.30、0.88,均P>0.05)。单孔组患者术后0d、1d、2d需求额外止痛剂均显著低于常规组(χ2值分别为10.16、11.45,均P<0.05)。结论卵巢成熟性囊性畸胎瘤患者使用单孔腹腔镜术更为切实可行,可以减少术后疼痛和止痛需求。Objective To assess the influence of laparoendoscopic single-site surgery（ LESS） on intraoperative and postoperative outcomes of women with ovarian mature cystic teratoma and to explore clinical application value of LESS by comparing it with conventional laparoscopic surgery. Methods Clinical data of 205 women with ovarian mature cystic teratoma was retrospectively analyzed,among which83 cases were treated with LESS and 122 cases were treated with conventional laparoscopic surgery. Intra- and postoperative outcomes were compared between two groups. Results Discharge rate at 1 day after operation in LESS group was significantly higher than that in conventional laparoscopic group（ P = 0. 02 0. 05）. There was no significant difference in tumor size,tumor location,appendix operation type,operation time,blood loss,transfusion needs,Hb level,length of hospital stay after operation,and postoperative complications between two groups（ t / χ2ranged from 0. 35 to 1. 37,all P〉0. 05）. Postoperative VAS pain score at 8h,16 h and 32 h after surgery in LESS group were significantly lower than that in conventional laparoscopic group（ t value was 1. 66,1. 64 and 3. 66,respectively,all P〈0. 05）,but there was no significant difference in pain score at 24 h and 40 h after surgery between two groups（ t value was 1. 30 and 0. 88,respectively,both P〉0. 05）. Demand for additional analgesics in LESS group at 0d,1d and 2d after surgery was significantly lower than that in conventional laparoscopic group（ χ2value was 10. 16 and 11. 45,respectively,both P〈0. 05）. Conclusion LESS is feasible for treatment of women with ovarian mature cystic teratoma,which can reduce postoperative pain and analgesia demand.

关 键 词：单孔腹腔镜术 成熟性囊性畸胎瘤 临床结局 影响 

分 类 号：R713.6[医药卫生—妇产科学]