常规器械下经脐单孔腹腔镜全子宫切除术治疗子宫良性病变的疗效观察  

Clinical observation of the curative effect of transumbilical single-hole laparoscopic total hysterectomy for benign uterine lesions under conventional instruments

作　　者：陈义波 龙玲 张静[1] 刘广申 林蓓蓓[1] 郭海春 Chen Yibo;Long Ling;Zhang Jing;Liu Guangshen;Lin Beibei;Guo Haichun(Department of Obstetrics and Gynecology,Changsha Maternal and Child Health Care Hospital Affiliated to Hunan Normal University,Changsha Hunan 410007,P.R.China)

机构地区：[1]湖南师范大学附属长沙市妇幼保健院妇科,湖南长沙410007

出　　处：《中国计划生育和妇产科》2022年第12期91-95,I0001,共6页Chinese Journal of Family Planning & Gynecotokology

基　　金：湖南省科技厅临床医疗技术创新引导项目(项目编号:2020SK53104)。

摘　　要：目的 比较常规器械经脐单孔腹腔镜与传统腹腔镜全子宫切除术治疗子宫良性病变的临床疗效及安全性。方法 回顾性分析2019年1月至2021年10月在湖南师范大学附属长沙市妇幼保健院住院手术治疗的全子宫切除患者共109例,按手术方式分为常规器械经脐单孔腹腔镜组(观察组,56例)和传统腹腔镜组(对照组,53例)。比较两组患者术中及术后并发症发生情况、手术时间、术后恢复情况、术后疼痛评分以及对切口美容满意度、术后住院时间等方面的差异。结果 观察组的手术时间、出血量和输血量与对照组比较差异无统计学意义(P>0.05);观察组术后肛门排气时间、术后住院时间、术后疼痛评分低于对照组,术后切口美容满意度评分高于对照组,差异均有统计学意义(P<0.05)。结论 相比于传统的腹腔镜手术,常规器械经脐单孔腹腔镜下全子宫切除术更能满足女性患者的美容要求,显著减轻术后疼痛,缩短术后肛门排气时间及住院时间,且不增加手术时间、术中出血以及并发症的发生率,该手术安全可行,耗材成本低、经济效益高,有望在基层医院中推广应用。Objective To compare the clinical efficacy and safety of conventional transumb: lical single-port laporoscopy and traditional laparoslopic total hysterectomy in the treatment of benign uterine lesions.Methods A total of 109 patients with total hysterectomy who were admitted to Changsha Maternal and Child Health Care Hospital Affiliated to Hunan Normal University for surgical treatment from January 2019 to October 2021 were retrospectively analyzed, and they were divided into conventional instrument transumbilical single-port laparoscopic group obsenation group 56 cases and traditional laparoscopic group control group 53 cases according to the surgical methods.The differences of intraoperative and postoperative complications, operation time, postoperative recovery, postoperative pain score, aesthetic satisfaction on the incision and postoperative hospital stay were compared between the two groups.Results There was no significant difference in operation time, blood loss and blood transfusion between the observation group and the control group(P>0.05).The score of postoperative anal exhaust time, postoperative hospital stay and postoperative pain in the observation group was lower than that in the control group, while the score of postoperative incision aesthetic satisfaction was higher than that in the control group, with statistical significance(P<0.05).Conclusion Compared with traditional laparoscopic surgery, total hysterectomy with conventional instruments via umbilical single-hole laparoscopic can better meet the cosmetic requirements of female patients, significantly reduce postoperative pain, shorten postoperative anal exhaust time and hospital stay, and do not increase the operation time, intraoperative bleeding and the incidence of complications.This surgery is safe and feasible, with low cost of consumables and high economic benefits.It is expected to be popularized and applied in primary hospitals.

关 键 词：常规器械 经脐单孔腹腔镜手术 传统腹腔镜 全子宫切除术 学习曲线 

分 类 号：R713.42[医药卫生—妇产科学]