腹腔镜技术在中期妊娠卵巢良性肿瘤蒂扭转的应用  

Application of laparoscopy y in torsion of ovarian benign tumors in the second trimester of pregnancy

作　　者：杨鸿 李俊强 马多娜 潘峰 许鑫玥 蔡春华 Yang Hong;li Junqiang;Ma Duona;Pan Feng;Xu Xinyue;Cai Chunhua(Department of Obstetrics and Gynaecology,Afiliated Hospital of Southvest Jiaotong University(Chengdu Third People's Hospital),Chengdu Sichuan 610031;Department of Obstetrics and Gynaecology,Sichuan Jinxin Women and Children's Hospital,Chengdu Sichuan 610011;Department of Interventional Medicine,Affiliated Hospital of Southavest Medical University,Luzhou Sichuan 646000,P.R.China.)

机构地区：[1]西南交通大学附属医院(成都市第三人民医院)妇产科,四川成都6100311 [2]四川锦欣妇女儿童医院妇产科,四川成都610011 [3]西南医科大学附属医院介入医学部,四川成都646000

出　　处：《中国计划生育和妇产科》2023年第2期73-76,共4页Chinese Journal of Family Planning & Gynecotokology

基　　金：国家自然科学基金面上项目(项目编号:81971636);四川省卫生和计划生育委员会科研基金(项目编号:17PJ254)。

摘　　要：目的 探讨腹腔镜技术在治疗中期妊娠卵巢良性肿瘤蒂扭转的疗效及安全性。方法 回顾性分析西南交通大学附属医院、四川锦欣妇女儿童医院及西南医科大学附属医院2016年1月至2021年12月收治的127例中期妊娠卵巢良性肿瘤蒂扭转患者临床资料,比较开腹组(62例)、腹腔镜组(65例)手术及术后相关指标、平均住院日、住院费用和妊娠结局。结果 两组孕周、肿瘤大小、扭转周数、保留卵巢比例差异无统计学意义(P>0.05);腹腔镜组手术时间、术中出血量、通气时间、切口愈合不良率、平均住院日为(80.73±19.19)min、(22.31±11.37)mL、(24.31±17.23)h、1.53%、(5.22±1.49)d,均低于开腹组[(101.39±15.56)min、(29.84±17.45)mL、(43.15±13.28)h、11.29%、(6.47±1.23)d],差异有统计学意义(P<0.05);腹腔镜组住院费用高于开腹组[(14 467.26±1 829.51)元vs (10 387.84±1 745.62)元](P<0.05)。两组均无胎儿畸形情况发生,流产率、早产率和胎儿出生体重比较,差异无统计学意义(P>0.05)。结论 中期妊娠卵巢良性肿瘤蒂扭转经腹腔镜路径手术较开腹手术安全可靠,术后肠道功能恢复快,住院时间短,虽住院费用有所增加,但降低了切口愈合不良的风险,且不增加不良妊娠结局。ObjectiveTo investigate the efficacy and safety of laparoscopic technique in the treatment of torsion of ovarian benign tumors in the second trimester of pregnancy.Methods The clinical data of 127 patients with torsion of ovarian benign tumors in the second trimester of pregnancy admited to the Afiliated Hospital of Southwest Jiaotong University,Sichuan Jinxin Women and Children's Hospital and Afiliated Hospital of Southwest Medical University from January 2016 to December 2021 were retrospectively analyzed.Compared the intraoperative and postoperative relevant indexes,average hospital stay,hospitalization costs and pregnancy outcomes between the the laparotomy group(62 cases)and the laparoscope group(65 cases).Results Therewas no statistically significant difference in the gestational age,tumor size,the coils number of torsion and the proportion of patients with retained ovaries between the two groups(P>0.05).The operation time,intraoperative blood loss,ventilation time,poor incision healing rate,and average hospitalization days in the laparoscope group were(80.73±19.19)min,(22.31±11.37)mL,(24.31±17.23)h,1.53%and(5.22±1.49)d,respectively,which were lower than those in the laparotomy group[(101.39±15.56)min,(29.84±17.45)mL,(43.15±13.28)h,11.29%and(6.47±1.23)d],the difference was statistically significant(P<0.05).The hospitalization cost of laparoscope group was higher than that of laparotomy group[(14467.26±1829.51)yuan vs(10387.84±1745.62)yuan](P<O0.05).There was no fetal anomaly in both groups,and the differences in miscarriage rate,premature delivery rate and fetal weight were not statistically significant(P>0.05).ConclusionThe laparoscopic for torsion of ovarian benign tumor pedicle torsion in the second trimester of pregnancy is safer and more reliable than laparotomy,with rapid postoperative intestinal function recovery and short hospitalization time.It costs more,but reduces the risk of poor incision healing rate and does not increase the adverse pregnancy outcomes.

关 键 词：中期妊娠 卵巢良性肿瘤 蒂扭转 经腹 经腹腔镜 

分 类 号：R714[医药卫生—妇产科学] R737.31[医药卫生—临床医学]