经脐单孔腹腔镜大子宫切除术的临床效果  

Clinical effect of transumbilical laparoscopic single-site surgery in large hysterectomy

作　　者：崔素芬 丁艳 于克 周金金 刘海燕 CUI Sufen;DING Yan;YU Ke;ZHOU Jinjin;LIU Haiyan(Department of Gynecology and Obstetrics,the Affiliated Hospital of Yangzhou University,Yangzhou,Jiangsu,225012)

机构地区：[1]扬州大学附属医院妇产科,江苏扬州225012

出　　处：《实用临床医药杂志》2023年第24期93-96,共4页Journal of Clinical Medicine in Practice

基　　金：扬州大学附属医院新技术项目(2018009);江苏省妇幼健康科研项目(F202134)。

摘　　要：目的探讨经脐单孔腹腔镜大子宫切除术的临床可行性、安全性及优势。方法选取行腹腔镜大子宫切除术的患者82例为研究对象。其中,行经脐单孔腹腔镜手术患者41例为单孔组,行传统多孔腹腔镜手术患者41例为多孔组。比较2组患者的手术时间、术中出血量、术后24 h视觉模拟评分(VAS)、术后排气时间、术后病率、术后住院时间、切口美容评分、术后第1天炎症指标、中性粒细胞与淋巴细胞比值(NLR)、并发症发生情况及术前和术后的血红蛋白差值。结果2组患者手术均顺利完成,无中转开腹,且未发生严重手术并发症,单孔组未添加辅助孔。单孔组术后排气时间短于多孔组,术后24 h VAS评分、术后第1天NLR低于多孔组,术后切口美容度评分高于多孔组,差异有统计学意义(P<0.05)。结论在严格把握手术适应证的情况下,经脐单孔腹腔镜大子宫切除术安全性较好,可行性较高,其具有术后排气快、术后疼痛轻、免疫抑制轻以及切口美观等优势。Objective To investigate the clinical feasibility,safety and advantages of transumbilical laparoscopic single-site surgery in large hysterectomy.Methods A total of 82 patients with laparoscopic large hysterectomy were selected as the study objects.Among them,41 patients underwent transumbilical single-hole laparoscopic surgery(single-hole group)and 41 patients underwent traditional multi-hole laparoscopic surgery(multi-hole group).Operation time,intraoperative blood loss,24 h postoperative Visual Analogue Score(VAS),postoperative exhaust time,postoperative morbidity,postoperative hospital stay,cosmetic incision score,postoperative inflammatory index,neutrophil lymphocyte ratio(NLR),incidence of complications and the difference of hemoglobin before and after surgery were compared between the two groups.Results The operation was successfully completed in both groups without conversion to laparotomy,and no serious surgical complications occurred.No auxiliary holes were added in the single-hole group.The postoperative exhaust time in the single-hole group was significantly shorter than that in the multi-hole group,the VAS score at 24 h after surgery and NLR at the first day after surgery were significantly lower than those in the multi-hole group,and the aesthetic score of the postoperative incision was significantly higher than that in the multi-hole group(P<0.05).Conclusion Under the condition of strict control of surgical indications,transumbilical laparoscopic single-site surgery in large hysterectomy has good safety and high feasibility,and has the advantages of fast postoperative exhaust,relieved postoperative pain,light immunosuppression and a incision.

关 键 词：经脐单孔腹腔镜 传统腹腔镜手术 大子宫切除术 中性粒细胞与淋巴细胞比值 排气时间 

分 类 号：R713.4[医药卫生—妇产科学] R711.74[医药卫生—临床医学] R61