经脐单孔腹腔镜子宫肌瘤挖除术的临床研究  

Clinical study of transumbilical single-hole laparoscopic myomectomy

作　　者：雷慧 曹云桂 Lei Hui;Cao Yungui(Shanghai Jiading Maternal and Child Health Hospital, Shanghai, 201801, China)

机构地区：[1]上海嘉定妇幼保健院,上海201801

出　　处：《中外女性健康研究》2021年第9期6-8,17,共4页Women＇s Health Research

基　　金：上海市新一轮医学重点专科建设项目,项目编号:ZK2015B08。

摘　　要：目的:探讨经脐单孔腹腔镜子宫肌瘤挖除术的临床应用。方法:选取2018年1月至2019年6月本院行腹腔镜子宫肌瘤挖除术患者84例,分为经脐单孔腹腔镜组(45例)和常规三孔腹腔镜组(39例),比较两组的基本特征和手术结果。结果:两组患者的基础特征差异无统计学意义(P>0.05)。相对于常规腹腔镜组,经脐单孔组手术时间长、术中出血多、术后血红蛋白下降多,两组差异均有统计学意义(P<0.05)。但其住院时间、术后排气时间、术后6h VAS评分和术后24h VAS评分少,差异均有统计学意义(P<0.05)。此外,两组手术均未转开腹手术,但经脐单孔腹腔镜组有2例因盆腔粘连转为改良式单孔腹腔镜。术后常规三孔腹腔镜组发热3例,肠梗阻1例,单孔腹腔镜组发热2例,肠梗阻组0例,两组之间差异无统计学意义。结论:虽然单孔腹腔镜子宫肌瘤挖除术可能手术时间长、术中出血偏多,但其术后疼痛感少、住院时间少,该手术值得临床进一步广泛使用。Objective:To explore the clinical application of transumbilical Single-port Laparoscopic Surgery for myomectomy.Methods:From January 2018 to June 2019,84 patientswho underwent laparoscopic hysteromyoma removal in our hospital were selected.According to the treatment methods,they were divided into the transumbilical single-hole laparoscopic group(45 cases)and the conventional three-hole laparoscopic group(39 cases).We analyzed and compared the basic characteristics and surgical outcomes of the two groups of patients.Results:There was no significant difference in basic characteristics between the two groups(P>0.05).Compared to the conventional laparoscopic group,The operation time was longer,operative bleeding was more,and postoperative hemoglobin decreased morein transumbilical single-hole group,The difference between the two groups was statistically significant(P<0.05).However,the hospital stay,postoperative exhaust time,VAS score at 6 hours after surgery and VAS score at 24 hours after surgery were less,the differences were statistically significant(P<0.05).In addition,no to open the abdomen was performed in both groups,however 2 patients in the transumbilical single-hole laparoscopic group converted to modified single-hole laparoscopic due to pelvic adhesions.After the operation,there were 3 cases of fever and 1 case of intestinal obstruction in the conventional three-hole laparoscopic group,2 cases of fever in the single-hole laparoscopic group and 0 cases of intestinal obstruction group,and the difference between the two groups was not statistically significant.Conclusion:Although single-hole laparoscopic hysteromyoma removal may take a longer time and have more intraoperative bleeding,it has less postoperative pain and less hospital stay,so it is worthy of further extensive clinical use.

关 键 词：经脐单孔腹腔镜 子宫肌瘤 可行性 

分 类 号：R737.33[医药卫生—肿瘤]