单孔腹腔镜手术治疗卵巢囊肿与输卵管妊娠临床疗效分析  

Clinical analysis of single-port laparoscopic surgery for ovarian cysts and tubal pregnancy

作　　者：程秋瑾 殷莉 CHENG Qiujin;YIN Li(Department of Gynecology and Obstetrics,Qianjiang Hospital,People's Hospital of Wuhan University,Qian-jiang 433100,Hubei,China;Department of Gynecology and Obstetrics,Tongji Hospital,Tongji Medi-cal College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China)

机构地区：[1]武汉大学人民医院潜江医院妇产科,湖北潜江433100 [2]华中科技大学同济医学院附属同济医院妇产科,湖北武汉430030

出　　处：《中国现代手术学杂志》2024年第6期476-481,共6页Chinese Journal of Modern Operative Surgery

摘　　要：目的探讨单孔腹腔镜手术治疗卵巢囊肿和输卵管妊娠的有效性和安全性。方法回顾性分析2022年8月至2024年4月行腹腔镜手术治疗的100例患者,按手术方式分为两组:单孔腹腔镜手术组(SL组)50例,其中卵巢囊肿28例,输卵管妊娠22例,分别行单孔腹腔镜卵巢囊肿剔除术(SL-A组)和输卵管切除术(SL-B组);传统腹腔镜手术组(CL组)50例,其中卵巢囊肿28例,输卵管妊娠22例,分别行传统多孔腹腔镜卵巢囊肿剔除术(CL-A组)和输卵管切除术(CL-B组)。比较两组手术操作时间、术中出血量、术后疼痛VAS评分、术后住院时间和患者满意度,并对卵巢囊肿大小与手术时间进行相关性分析。结果所有手术均顺利完成。术后24 h内拔除导尿管,无一例尿潴留。在卵巢囊肿剔除术中,SL-A组手术时间较CL-A组延长[(44.7±9.5)min vs.(36.5±13.8)min],术中出血量大于CL-A组[(55.3±29.8)mL vs.(27.7±13.3)mL],差异均有统计学意义(P<0.05),而两组术后疼痛VAS评分、住院时间和患者满意度比较均无统计学差异(P>0.05)。输卵管切除术中,SL-B组术中出血量亦高于CL-B组[(26.8±12.5)mL vs.(18.8±8.3)mL],VAS评分明显低于CL-B组[(2.3±1.7)分vs.(3.8±2.5)分],差异均有统计学意义(P<0.05),而组间手术时间、术后住院时间以及患者满意度比较均无统计学差异(P>0.05)。此外,卵巢囊肿的大小与手术时间在两组中均呈现显著正相关(SL-A组r=0.665,P<0.0001;CL-A组r=0.693,P<0.0001)。结论单孔腹腔镜手术治疗卵巢囊肿与输卵管妊娠安全有效,且切口更隐蔽美观,美容效果佳,值得在临床上推广应用。Objective To evaluate the efficacy and safety of laparoendoscopic single-site surgery(LESS)in the treatment of ovarian cysts and tubal pregnancy.Methods A retrospective analysis was conducted on 100 patients who underwent laparoscopic surgery in our hospital from August 2022 to April 2024.The patients were divided into two groups based on the surgical approach:the single-port laparoscopic surgery group(SL group,n=50),including 28 cases of ovarian cysts and 22 cases of tubal pregnancy,who underwent single-port laparoscopic ovarian cystectomy(SL-A group)or salpingectomy(SL-B group);and the traditional通信作者:殷莉,邮箱:[e-mail] multi-port laparoscopic surgery group(CL group,n=50),including 28 cases of ovarian cysts and 22 cases of tubal pregnancy,who underwent traditional multi-port laparoscopic ovarian cystectomy(CL-A group)or salpin-gectomy(CL-B group).The operation time,intraoperative blood loss,postoperative pain visual analog scale(VAS),length of postoperative hospital stay,and patient satisfaction were compared between the two groups.Additionally,the correlation between ovarian cyst diameter and operation time in ovarian cystectomy was analyzed.Results All laparoscopic surgeries were successfully completed without complications.The urinary catheter was removed within 24 hours postoperatively,and no urinary retention was observed.In ovarian cystectomy,the operation time of the SL-A group was significantly longer than that of the CL-A group[(44.7±9.5)min vs.(36.5±13.8)min,P<0.05],and the intraoperative blood loss was also significantly greater in the SL-A group compared to the CL-A group[(55.3±29.8)mL vs.(27.7±13.3)mL,P<0.05].However,there were no significant differences between the two groups in terms of postoperative VAS scores,length of postoperative hospital stay,or patient satisfaction(P>0.05).In salpingectomy,the intraoperative blood loss of the SL-B group was significantly higher than that of the CL-B group[(26.8±12.5)mL vs.(18.8±8.3)mL,P<0.05],while the postoperative VAS score

关 键 词：单孔腹腔镜手术 卵巢囊肿 输卵管妊娠 卵巢囊肿剔除术 输卵管切除术 

分 类 号：R71[医药卫生—妇产科学]