经阴道自然腔道内镜与经脐单孔腹腔镜在妇科良性疾病全子宫切除术中应用效果的对比分析  

Comparative analysis of the application effect of transvaginal natural endoscopy and transumbilical single-hole laparoscopy in total hysterectomy for benign gynecological diseases

作　　者：陈金玲 冯元元 饶珺 Chen Jin-ling;Feng Yuan-yuan;Rao Jun(Department of Obstetrics and Gynecology,Xinyang Central Hospital,Xinyang 464000,Henan,China)

机构地区：[1]信阳市中心医院妇产科,河南信阳464000

出　　处：《四川生理科学杂志》2025年第1期95-97,175,共4页

摘　　要：目的:对比经脐单孔腹腔镜和经阴道自然腔道内镜手术在妇科良性疾病全子宫切除术中临床应用效果。方法:回顾性收集2021.05-2023.05期间本院收治的99例行全子宫切除术患者的临床资料。根据治疗方法的不同,将患者分为对照组(经脐单孔腹腔镜手术治疗,47例)和研究组(经阴道自然腔道内镜手术治疗,52例)。分析比较两组的围术期相关指标、盆底功能[盆底功能障碍问卷(Pelvic floor distress inventory-short form 20,PFDI-20)]、应激反应[5-羟基色胺(5-Hydroxytryptamine,5-HT)、丙二醛(Malonaldehyde,MDA)、谷胱肽过氧化物酶(Glutathione peroxidase,GPX)、蛋白氧化产物(Advanced oxidation protein products,AOPP)]以及并发症。结果:研究组的肛门排气时间、下床活动时间、出血量、手术时间、住院时间均比对照组显著降低(P<0.05)。术后2 w及术后4 w,两组的盆底功能障碍问卷(PFDI-20)评分均比术前显著降低,且研究组的PFDI-20评分比对照组显著降低(P<0.05)。术后2 w,两组的血清5-HT、MDA、GPX、AOPP水平均比术前显著降低,且研究组的血清5-HT、MDA、GPX、AOPP水平均显著低于对照组(P<0.05)。两组的并发症发生率无显著差异(P>0.05)。结论:经阴道自然腔道内镜引导全子宫切除术能减少对盆底功能损伤,减轻机体应激反应,促进患者恢复,且安全性较好。Objective:To compare the clinical effects of transumbilical single-hole laparoscopic and transvaginal natural endoscopy in total hysterectomy for benign gynecological diseases.Methods:The clinical data of 99 patients with total hysterectomy admitted to our hospital during 2021.05-2023.05 were retrospectively collected.According to the different treatment methods,the patients were divided into control group(transumbilical single-hole laparoscopic surgery,47 cases)and study group(transvaginal natural endoscopic surgery,52 cases).Perioperative correlation indexes,pelvic floor function[pelvic floor distress inventory-short form 20(PFDI-20)],stress response[5-hydroxytryptamine(5-HT),malondialdehyde(MDA),glutathione peroxidase(GPX),advanced oxidation protein products(AOPP)]and complications were analyzed and compared between the two groups.Results:The time of anal exhaust,the time of getting out of bed,the amount of blood loss,the time of operation and the time of hospitalization in the study group were significantly reduced than those in the control group(P<0.05).At 2 and 4 weeks after surgery,PFDI-20 scores of both groups were significantly lower than those before surgery,and PFDI-20 scores of the study group were significantly lower than those of the control group(P<0.05).Two weeks after surgery,the levels of serum 5-HT,MDA,GPX and AOPP in both groups were significantly lower than before surgery,and the levels of serum 5-HT,MDA,GPX and AOPP in the study group were significantly lower than those in the control group(P<0.05).There was no significant difference in the incidence of complications between the two groups(P>0.05).Conclusion:Total hysterectomy guided by natural vaginal endoscope can reduce the damage of pelvic floor function,reduce the stress response of the body,and promote the recovery of patients,with good safety.

关 键 词：经脐单孔腹腔镜 经阴道自然腔道内镜 全子宫切除术 

分 类 号：R47[医药卫生—护理学]