疝针辅助脐周两孔腹腔镜与经脐单孔腹腔镜附件切除术的对比研究  

Comparative Study on Hernia Needle Assisted Periumbilical Two-port Laparoscopy and Transumbilical Single-port Laparoscopy in Salpingo-oophorectomy

作　　者：潘晓雨 张思佳 郭亮生[1] 任琼珍[1] 陶晓敏[1] 戴淑榕 唐怡璇 朱维培[1] Pan Xiaoyu;Zhang Sijia;Guo Liangsheng(Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, Suzhou 215004, China)

机构地区：[1]苏州大学附属第二医院妇产科,苏州215004

出　　处：《中国微创外科杂志》2021年第6期500-504,共5页Chinese Journal of Minimally Invasive Surgery

基　　金：江苏省卫生健康委员会科研项目(QNRC2016881,F201922);苏州市科技计划项目(SYSD2019106,SYS2020134)。

摘　　要：目的探讨疝针辅助脐周两孔腹腔镜与经脐单孔腹腔镜在附件切除手术中的临床疗效。方法回顾性分析2016年1月~2019年10月我院120例附件良性病变行腹腔镜附件切除术的临床资料,按手术方式分为疝针两孔组(60例)与单孔组(60例),疝针两孔组行疝针辅助脐周两孔腹腔镜附件切除手术,单孔组行单孔腹腔镜附件切除手术,比较2组患者术中及术后一般情况、住院费用、术后24和48 h切口疼痛数字评分(Numeric Rating Scale,NRS)、Hollander切口愈合评分和切口并发症发生率。结果2组患者均顺利完成手术,术中无并发症发生。术后病理提示均为附件良性病变。疝针两孔组手术时间(42.2±17.6)min,明显短于单孔组(58.8±22.8)min(t=4.463,P=0.000)。2组术中出血量、术后住院时间差异无统计学意义(P>0.05)。疝针两孔组住院费用(11701.0±56.1)元,明显少于单孔组(15286.9±46.5)元(t=381.250,P=0.000)。疝针两孔组术后24、48 h切口疼痛NRS评分、Hollander切口愈合评分均明显优于单孔组(t=13.048,P=0.000;t=8.870,P=0.000;t=-5.322,P=0.000)。疝针两孔组术后切口并发症发生率1.7%(1/60),明显低于单孔组21.7%(13/60)(χ^(2)=11.644,P=0.001)。结论疝针辅助脐周两孔腹腔镜附件切除术安全可行,与单孔腹腔镜手术相比,缩短手术时间、减少术后疼痛及并发症,而且切口愈合情况更好,住院费用更低。Objective To investigate the application value of hernia needle assisted periumbilical two-port laparoscopy and transumbilical single-port laparoscopy in salpingo-oophorectomy.Methods Clinical data of 120 female patients with benign adnexal lesions undergoing laparoscopic salpingo-oophorectomy from January 2016 to October 2019 in our hospital were retrospectively analyzed.The patients were divided into hernia needle two-port group(n=60)and single-port group(n=60).The hernia needle two-port group underwent hernia needle assisted periumbilical two-port laparoscopic salpingo-oophorectomy,while the single-port group underwent single-port laparoscopic salpingo-oophorectomy.The intraoperative and postoperative general conditions,hospitalization expenses,Numeric Rating Scales(NRS)of incision pain 24 and 48 h after operation,Hollander Wound Evaluation Scales,and incidence of incision complications were compared between the two groups.Results The operations were completed successfully without complications during the operation in both groups of patients.Postoperative pathology showed benign adnexal lesions in all the patients.The operation time of the hernia needle two-port group(42.2±17.6)min was significantly less than that of the single-port group(58.8±22.8)min(t=4.463,P=0.000).There was no significant difference in blood loss and postoperative hospital stay between the two groups(P>0.05).The hospitalization expenses of the hernia needle two-port group(11701.0±56.1)yuan was less than that of the single-port group(15286.9±46.5)yuan(t=381.250,P=0.000).The 24 and 48 h postoperative NRS and Hollander Wound Evaluation Scales of the hernia needle two-port group were better than those of the single-port group(t=13.048,P=0.000;t=8.870,P=0.000;t=-5.322,P=0.000).The wound complication rate of the hernia needle two-port group was 1.7%(1/60),which was significantly lower than that in the single-port group[21.7%(13/60),χ^(2)=11.644,P=0.001].ConclusionsCompared with single-port laparoscopic surgery,hernia needle assisted perium

关 键 词：疝针 腹腔镜手术 单孔腹腔镜手术 腹腔镜附件切除术 

分 类 号：R65[医药卫生—外科学]