常规腹腔镜与迷你腹腔镜手术治疗子宫内膜异位症的比较  

Comparison Between Mini-laparoscopy and Conventional Laparoscopy for Endometriosis

作　　者：淡堰璇 张震宇 Dan Yanxuan;Zhang Zhenyu(Department of Obstetrics and Gynecology,Beijing Huafu Women&Children’s Hospital,Beijing 100024,China)

机构地区：[1]北京华府妇儿医院妇产科,北京100024 [2]北京市西城区妇幼保健院妇女保健中心,北京100054 [3]首都医科大学附属北京朝阳医院妇产科,北京100020

出　　处：《中国微创外科杂志》2018年第4期313-315,322,共4页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨常规腹腔镜与迷你腹腔镜手术治疗子宫内膜异位症(endometriosis,EM)的疗效。方法对2015年9月~2016年11月就诊于北京华府妇儿医院的35例EM分别行迷你腹腔镜(迷你腹腔镜组,15例)或常规腹腔镜(常规腹腔镜组,20例)保守性手术,观察2组患者围手术期指标、并发症发生率及症状缓解有效率。结果迷你腹腔镜组手术时间(68.2±2.1)min,显著短于常规腹腔镜组(78.4±2.3)min(t=13.468,P=0.000);迷你腹腔镜组术中出血量(12.1±6.7)ml,显著少于常规腹腔镜组(21.4±7.8)ml(t=-3.703,P=0.000);迷你腹腔镜组胃肠功能恢复时间(21.5±7.6)h,显著短于常规腹腔镜组(28.6±7.4)h(t=-2.777,P=0.009);迷你腹腔镜组住院(2.7±1.1)d,显著短于常规腹腔镜组(3.7±1.1)d(t=-2.662,P=0.012);迷你腹腔镜组术后并发症发生率6.7%(1/15),显著低于常规腹腔镜组40.0%(8/20)(Fisher精确检验,P=0.048)。术后病理:迷你腹腔镜组6例深部浸润型EM,9例盆腔EM,7例合并卵巢巧克力囊肿;常规腹腔镜组13例深部浸润型EM,7例盆腔EM,10例合并卵巢巧克力囊肿。随访时间3~9个月,其中迷你腹腔镜组15例随访(6.2±2.8)月,常规腹腔镜组20例随访(6.8±2.6)月。2组症状缓解有效率[93.3%(14/15)vs.85.0%(17/20)]、复发率[(20.0%(3/15)vs.20.0%(4/20)]差异无统计学意义(Fisher精确检验,P=0.619,P=1.000)。结论迷你腹腔镜手术治疗EM具有切口小,住院时间短,术后并发症少等优点,值得临床推广。Objective To investigate the efficacy of conventional laparoscopy and mini-laparoscopic surgery in the treatment of endometriosis(EM). Methods From September 2015 to November 2016,35 cases of endometriosis were treated with mini-laparoscopic surgery(mini group,15 cases)or conventional laparoscopic surgery(conventional group,20 cases)in Beijing Huafu Women&Children’s Hospital.The peri-operative parameters,incidence of complications,and symptom relief rate were observed in both groups. Results The operation time was(68.2±2.1)min in the mini group,which was significantly shorter than that in the conventional group[(78.4±2.3)min,t=13.468,P=0.000].The intraoperative blood loss was significantly less in the mini group(12.1±6.7)ml than that in the conventional group[(21.4±7.8)ml,t=-3.703,P=0.000].The recovery time of gastrointestinal function was significantly lower in the mini group(21.5±7.6)h than that in the conventional group[(28.6±7.4)h,t=-2.777,P=0.009].The hospital stay was significantly shorter in the mini group(2.7±1.1)d than that in the conventional group[(3.7±1.1)d,t=-2.662,P=0.012].The incidence of postoperative complications was 6.7%(1/15)in the mini group,which was significantly lower than that in the conventional group[40.0%(8/20),Fisher exact test,P=0.048].Postoperative pathology:the mini group had 6 cases of deep infiltration type EM,9 cases of pelvic EM,and 7 cases of ovarian chocolate cysts;the traditional group had 13 cases of deep infiltration type EM,7 cases of pelvic EM,and 10 cases of ovarian chocolate cysts.The follow-up time was 3-9 months,including 15 cases in the mini group for(6.2±2.8)months and 20 cases in the conventional group for(6.8±2.6)months.There was no significant difference between the two groups in symptom relief rate[93.3%(14/15)vs.85.0%(17/20)]and the recurrence rate[20.0%(3/15)vs.20.0%(4/20),Fisher exact test,P=0.619 and 1.000]. Conclusion Mini-laparoscopic surgery for EM has advantages of small incision,shorter hospital stay,and less postoperative complications,bei

关 键 词：迷你腹腔镜 子宫内膜异位症 

分 类 号：R713[医药卫生—妇产科学]