改良经脐单孔腹腔镜子宫肌瘤剔除术的临床应用效果分析  

Analysis of clinical effect of modified transumbilical laparoendoscopic single-site myomectomy

作　　者：刘合芳 董一善 戚慧 LIU He-fang;DONG Yi-shan;QI Hui(General Gynecology Department,Changzhou Maternity and Child Health Care Hospital,Changzhou 213003,China)

机构地区：[1]常州市妇幼保健院普通妇科,213003

出　　处：《中国现代药物应用》2024年第14期43-46,共4页Chinese Journal of Modern Drug Application

摘　　要：目的评估改良经脐单孔腹腔镜子宫肌瘤剔除术的临床应用价值。方法回顾性分析行腹腔镜下子宫肌瘤剔除术患者75例,按手术方式不同分为改良经脐单孔腹腔镜组(38例,行改良经脐单孔腹腔镜子宫肌瘤剔除术,脐部自制Port及左下腹0.5 cm预置引流孔)、传统多孔腹腔镜组(37例,行传统多孔腹腔镜子宫肌瘤剔除术)。比较两组手术时间,术中出血量,术后引流管拔除时间,抗生素使用情况,术后住院时间,住院费用。结果改良经脐单孔腹腔镜组与传统多孔腹腔镜组的手术时间[(76.26±22.10)min VS(83.24±22.21)min,P=0.177]及术中出血量[(55.52±32.85)ml VS(63.51±27.71)ml,P=0.259]比较,差异无统计学意义(P>0.05);改良经脐单孔腹腔镜组与传统多孔腹腔镜组的术后引流管拔除时间[(48.42±19.16)h VS(64.72±21.87)h,P=0.001]及术后住院时间[(4.18±1.01)d VS(5.08±1.08)d,P=0.000]比较改良经脐单孔腹腔镜组更短,抗生素使用率[31.58%(12/38)VS 54.05%(20/37),P=0.049]及住院费用[(14.02±2.2)千元VS(15.73±2.8)千元,P=0.004]比较改良经脐单孔腹腔镜组更低(P<0.05)。结论改良经脐单孔腹腔镜子宫肌瘤剔除术兼顾无瘤化操作及更微创的手术效果,通过改良手术步骤,使其手术难度与传统多孔腹腔镜相比无明显增加,值得临床推广。Objective To assess the clinical application value of modified transumbilical laparoendoscopic single-site myomectomy.Methods 75 patients who underwent laparoscopic myomectomy were retrospectively analyzed.They were divided into modified transumbilical laparoendoscopic single-site group(38 cases,modified transumbilical laparoendoscopic single-site myomectomy,with homemade port and a 0.5 cm conducting hole at the McBurney's point)and conventional laparoscopic group(37 cases,conventional laparoscopic myomectomy)according to different surgical methods.The operation time,intraoperative blood loss,postoperative drainage tube removal time,antibiotic use,postoperative hospitalization time and hospitalization cost were compared between the two groups.Results The operation time[(76.26±22.10)min VS(83.24±22.21)min,P=0.177]and intraoperative blood loss[(55.52±32.85)ml VS(63.51±27.71)ml,P=0.259]were compared between the modified transumbilical laparoendoscopic single-site group and the conventional laparoscopic group,and the difference was not statistically significant(P>0.05).Postoperative drain removal time[(48.42±19.16)h VS(64.72±21.87)h,P=0.001]and postoperative hospitalization time[(4.18±1.01)d VS(5.08±1.08)d,P=0.000]were compared between the modified transumbilical laparoendoscopic single-site group and the conventional laparoscopic group,which were shorter in the modified transumbilical laparoendoscopic singlesite group;the antibiotic use rate[31.58%(12/38)VS 54.05%(20/37),P=0.049]and hospitalization cost[(14.02±2.2)thousand yuan VS(15.73±2.8)thousand yuan,P=0.004]were compared,which were lower in the modified transumbilical laparoendoscopic single-site group(P<0.05).Conclusion Modified transumbilical laparoendoscopic single-site myomectomy gives consideration to non tumorous operation and more minimally invasive surgical effect.By improving the surgical procedures,the difficulty of the operation is not significantly increased compared with the conventional laparoscopic surgery,which is worthy of clinical pr

关 键 词：改良经脐单孔腹腔镜手术 传统多孔腹腔镜手术 子宫肌瘤剔除术 

分 类 号：R737.33[医药卫生—肿瘤]