单孔腹腔镜与传统腹腔镜在妇科常见手术中的应用比较  

Surgical outcome of single-incision laparoscopy and conventional laparoscopy for common gynecological diseases

作　　者：张坤[1] 王一婷[1] 姚颖[1] 吴章鑫 杨俊芳[1] 韩劲松[1] 郭红燕[1] ZHANG Kun;WANG Yiting;YAO Ying;WU Zhangxin;YANG Junfang;HAN Jinsong;GUO Hongyan(Department of obstetrics and gynecology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院妇产科

出　　处：《中国生育健康杂志》2020年第1期28-31,50,共5页Chinese Journal of Reproductive Health

摘　　要：目的探讨单孔腹腔镜在妇科常见手术中的应用价值。方法选取2016年4月—2018年8月在本院实施的单孔腹腔镜手术66例作为单孔腹腔镜组,其中输卵管切除27例,附件囊肿剔除术25例,全子宫附件切除14例;选取相同疾病的传统腹腔镜手术66例作为传统腹腔镜组,比较手术时间、切口开关时间、手术操作时间、术中出血量、术后疼痛评分(采用视觉模拟评分法,简称VAS评分)、术后住院时间、患者满意度情况。结果两组均成功实施手术,无手术并发症发生。单孔腹腔镜组附件手术总时间(37.5±11.2)min、切口开关时间(8.4±2.6)min、手术操作时间(27.4±10.4)min,均明显长于传统腹腔镜组(20.1±6.4)min、(3.5±0.4)min、(18.1±7.9)min,差异有统计学意义(P<0.001);单孔腹腔镜组术中出血量(10.2±3.9)ml、术后疼痛VAS评分(4.4±1.3)分均高于传统腹腔镜组(3.5±1.6)ml、(2.7±0.8)分,差异有统计学意义(P<0.001)。单孔腹腔镜组子宫切除手术总时间(62.1±22.1)min、切口开关时间(7.9±2.9)min、手术操作时间(45.5±19.3)min,均明显长于传统腹腔镜组(41.2±12.4)min、(3.4±0.7)min、(32.1±9.9)min,差异有统计学意义(P<0.05);单孔腹腔镜组术中出血量(25.7±12.6)ml、术后疼痛VAS评分(5.1±1.6)分高于传统腹腔镜组(12.4±3.8)ml、(3.4±1.4)分,差异有统计学意义(P<0.05)。单孔腹腔镜组对手术的主观评价明显优于传统腹腔镜组,非常满意率分别为72.7%(48/66)和59.1%(39/66)。结论单孔腹腔镜行妇科常见手术,手术时间、操作难度增加,但切口美观隐匿,患者治疗满意度增加,在妇科疾病的治疗中有一定的应用价值。Objective The aim of this study is to compare the surgical outcome of single-incision laparoscopy with conventional laparoscopy for common gynecological diseases.Methods The study group contains 66 patients,who underwent single-incision laparoscopic surgery(including 27 cases of salpingectomy,25 cases of ovarian cystectomy,14 cases of total hysterectomy and bilateral salpingo-oophorectomy)in Peking University Third Hospital from Apr.2016 to Aug.2018.Control group included 66 patients underwent conventional laparoscopy due to the same diseases.The differences in clinical data including total operation time,incision time,operation time,amount of bleeding,The VAS score,hospital stay and patient satisfaction were compared between the two groups.Results Both groups underwent successful operations without surgical complications.In the study group of adnexa surgery,the average total operation time(37.5±11.2 vs.20.1±6.4 min)min,incision time(8.4±2.6 min vs.3.5±0.4 min),and operation time(27.4±10.4 min vs.18.1±7.9 min)were longer than those in the control group(all P values<0.001).Amount of bleeding(10.2±3.9 ml,vs.3.5±1.6 ml;t=11.461,P=0.000)and the VAS score(4.4±1.3 vs.2.7±0.8;t=8.031,P=0.000)were higher than those in the control group.In the study group of hysterectomy,the average total operation time(62.1±22.1 min vs.41.2±12.4 min),incision time(7.9±2.9 min vs.3.4±0.7 min),and operation time(45.5±19.3 min vs.32.1±9.9 min)were longer than those in the control group(all P values<0.05).Amount of bleeding(25.7±12.6 ml vs.12.4±3.8 ml)and the VAS score(5.1±1.6 vs.3.4±1.4)was higher than what in the control group(all P values<0.001).Subjective evaluation with great satisfactionin in study group was superior(72.7%,48/66)to that in the control group(59.1%,39/66).Conclusion Single-incision laparoscopy increased operational time and difficulties,but the treatment effect was superior and the incision was hidden,which increased the satisfaction of treatment.Single-incision laparoscopy has a certain practical val

关 键 词：单孔腹腔镜 传统腹腔镜 妇科手术 

分 类 号：R65[医药卫生—外科学]