经脐单孔腹腔镜下子宫次全切除术治疗子宫良性疾病的效果观察  

Efficacy of transumbilical laparoendoscopic single-site supracervical hysterectomy in the treatment of benign uterine diseases

作　　者：李雪莲[1] 毛熙光 Li Xuelian;Mao Xiguang(Department of Gynaecology,People's Hospital of Hechuan District of Chongqing,Chongqing 401520,China;Department of Gynaecology,The Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan Province,China)

机构地区：[1]重庆市合川区人民医院妇科,401520 [2]西南医科大学附属医院妇科,四川省泸州646000

出　　处：《中国基层医药》2021年第7期1048-1051,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：重庆市合川区指导性科技计划项目(合川科局发[2020]21号)。

摘　　要：目的观察经脐单孔腹腔镜下子宫次全切除术治疗子宫良性疾病的临床效果。方法回顾性分析重庆市合川区人民医院2018年1月至2019年12月腹腔镜下子宫次全切除的子宫体积<14孕周的良性子宫疾病患者39例的临床资料,根据手术路径分为经脐单孔组21例、多孔组18例,比较两组手术时间、标本取出时间、术中出血量、切口缝合时间、组织碎屑脱落率、术后下床时间、住院时间、术后第1天疼痛评分、肛门排气时间及术后30 d并发症发生率。结果单孔组术中组织碎屑脱落率为0.00%(0/21),低于多孔组的100.00%(18/18)(χ^(2)=39.00,P<0.001);单孔组手术时间[(74.20±9.15)min]长于多孔组[(62.90±6.20)min](t=3.323,P<0.05);单孔组标本取出时间[(11.10±2.33)min]、切口缝合时间[(3.90±0.88)min]长于多孔组的(4.90±0.88)min和(2.90±0.74)min,均差异有统计学意义(t=7.97、0.386,均P<0.05);两组术中出血量、术后下床时间、术后第1天疼痛评分、术后住院时间、肛门排气时间及术后30 d并发症发生率均差异无统计学意义(均P>0.05)。结论对于<14孕周子宫良性疾病腹腔镜下子宫次全切除术,经脐单孔可取得与多孔手术相当的近期手术效果,并可杜绝组织播散导致的远期并发症。Objective To investigate the efficacy of transumbilical laparoendoscopic single-site supracervical hysterectomy in the treatment of benign uterine diseases.Methods The clinical data of 39 patients with benign uterine diseases with the volume of uterus less than that at the 14 weeks of pregnancy who underwent supracervical hysterectomy in People's Hospital of Hechuan District of Chongqing,China between January 2018 and December 2019 were retrospectively analyzed.These patients were divided into transumbilical laparoendoscopic single-site supracervical hysterectomy group(single-site group,n=21)and transumbilical laparoendoscopic multiple-site supracervical hysterectomy group(multiple-site group,n=18)according to different surgical approaches.Operation time,specimen removal time,intraoperative blood loss,incision suture time,tissue debris shedding rate,postoperative off-bed time,length of hospital stay,pain score on postoperative day 1,time to anal exhaust,and the incidence of complications within 30 days after surgery were compared between the two groups.Results Tissue debris shedding rate in the single-site group was significantly lower than that in the multiple-site group[0.00%(0/21)vs.100.00%(18/18),χ^(2)=39.00,P<0.001].Operation time in the single-site group was significantly longer than that in the multiple-site group[(74.20±9.15)minutes vs.(62.90±6.20)minutes,t=3.323,P<0.05).Specimen removal time and incision suture time in the single-site group were(11.10±2.33)minutes and(3.90±0.88)minutes,respectively,which were significantly longer than those in the multiple-site group[(4.90±0.88)minutes,(2.90±0.74)minutes,t=7.97,0.386,both P<0.05].There were no significant differences in intraoperative blood loss,postoperative off-bed time,pain score on postoperative day 1,length of hospital stay,time to anal exhaust,and the incidence of complications within 30 days after surgery between the two groups(all P>0.05).Conclusion Transumbilical laparoendoscopic single-site and multiple-site supracervical hysterectomy ca

关 键 词：子宫疾病 子宫切除术 腹腔镜检查 手术时间 失血 手术 疼痛 手术后 住院时间 手术后并发症 

分 类 号：R713.42[医药卫生—妇产科学]