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中华腔镜外科杂志(电子版)

中华腔镜外科杂志(电子版) ›› 2019, Vol. 12 ›› Issue (06): 347 -350. doi: 10.3877/cma.j.issn.1674-6899.2019.06.008

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经脐单孔腹腔镜与传统腹腔镜治疗妇科良性疾病的对比研究
范秀华 1 , †( ), 耿艳红 2, 范佳佳 2, 罗滢 1, 王锋良 1, 张冉 1   
  1. 1. 100074 北京，中国航天科工集团七三一医院妇科
    2. 050000 石家庄，河北医科大学第二医院妇科
  • 收稿日期:2019-06-15 出版日期:2019-12-30
  • 通信作者: 范秀华

A comparative study of transumbilical laparoscopic single site surgery and traditional laparoscopy in the treatment of gynecological benign diseases

Xiuhua Fan 1 , †( ), Yanhong Geng 2, Jiajia Fan 2, Ying Luo 1, Fengliang Wang 1, Ran Zhang 1   

  1. 1. Department of Obstetrics and Gynecology, No.731 Hospital of China Aerospace Science & Industry Corporation, Beijing.People′s Republic of China, Beijing 100074, China
    2. The Second Hospital of Hebei Medical University, Shijiazhuang 050000, China
  • Received:2019-06-15 Published:2019-12-30
  • Corresponding author: Xiuhua Fan
  • About author:
    Corresponding author: Fan Xiuhua, Email:
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目的

通过经脐单孔腹腔镜与传统腹腔镜手术的对比研究，探讨经脐单孔腹腔镜手术在妇科良性疾病治疗中的应用价值。

方法

2016年11月至2018年1月在中国航天科工集团七三一医院及河北医科大学第二医院妇科收治的80例妇科良性疾病的患者，根据手术方式分为经脐单孔腹腔镜手术组及传统腹腔镜手术组，每组40例，对两组的手术时间、术中出血量、中转开腹率、术后排气时间、疼痛评分、住院时间、并发症进行比较。

结果

两组手术均成功，无中转开腹手术，随访至术后1年未发生并发症。两组的术中出血量、术后排气时间、住院时间相比，差异无统计学意义(P>0.05)；单孔腹腔镜手术组的手术时间长于传统腹腔镜手术组[(111.00±54.90)min比(79.67±42.45)min]，差异有统计学意义(P<0.05)；但单孔腹腔镜手术组术后3 d疼痛的视觉模拟评分低于传统腹腔镜手术组[(2.6±0.92)分比(2.0±0.98)分]，差异有统计学意义(P<0.05)。

结论

经脐单孔腹腔镜手术微创、安全可行，相较于传统腹腔镜手术能够明显减轻术后疼痛。

关键词: 妇科良性疾病, 经脐单孔腹腔镜手术, 传统腹腔镜
Objective

Through the comparative study of transumbilical laparoscopic single site surgery and traditional laparoscopy surgery, to explore the application value of transumbilical laparoscopic single site surgery in the treatment of gynecological benign diseases.

Methods

From Nov. 2016 to Jan. 2018, 80 patients with benign gynecological diseases were treated in the 731 Hospital of China Aerospace Science and Industry Corporation and the Second Hospital of Hebei Medical University. According to the surgical method, the patients were divided into two groups: transumbilical laparoscopic single site surgery group (n=40) and traditional laparoscopic surgery group (n=40). The operation time, intraoperative blood loss, conversion rate, postoperative exhaust time, pain, length of stay in hospital and complications were compared between the two groups.

Results

In both groups, the operation was successful and there was no conversion to laparotomy, and no complications occurred 1 year after follow-up. There was no significant difference in intraoperative blood loss, postoperative exhaust time and length of stay in hospital between the two groups. The operation time in the single site group was longer than that in the traditional group [(111.00 ±54.90)min vs (79.67±42.45) min]. The VAS pain score in the single site group was significantly lower than that in the traditional group at 3 days after operation [(2.6±0.92) vs (2.0±0.98)]. The difference was statistically significant (P<0.05). The visual analogue scale pain score in the single site group was significantly lower than that in the traditional group (P<0.05). The difference was statistically significant (P<0.05).

Conclusions

Transumbilical laparoscopic single site surgery is minimally invasive, safe and feasible. Compared with traditional laparoscopic surgery, the postoperative pain is obviously alleviated.

Key words: Benign gynecologic diseases, Transumbilical laparoscopic single site surgery, Traditional laparoscopy surgery
表1 妇科良性疾病患者的两组一般临床资料比较( ±s)
组别 例数 年龄(岁) 体质量指数(kg/m2) 肿物直径(cm)
传统腹腔镜手术组 40 32.13±7.20 23.34±3.17 5.88±2.29
单孔腹腔镜手术组 40 30.10±5.70 22.95±1.91 5.81±2.51
t值 ? 1.398 0.666 0.130
P值 ? >0.05 >0.05 >0.05
图1 单孔腹腔镜手术器械
图2 单孔腹腔镜手术入路平台远观
图3 单孔腹腔镜手术入路平台
表2 妇科良性疾病患者的两组临床疗效比较
组别 例数 术中出血量(ml) 术后排气时间(d, ±s) 术后住院时间(d, ±s) 手术时间(min, ±s) 术后3 d疼痛评分(分， ±s)
传统腹腔镜组 40 30.50(5.00～45.00) 1.48±0.48 9.37±2.77 79.67±42.45 2.6±0.92
单孔腹腔镜组 40 24.50(5.00～37.25) 1.43±0.50 9.70±4.76 111.00±54.90 2.0±0.98
t/Z值 ? 0.994 0.456 －0.379 －2.855 2.823
P值 ? >0.05 >0.05 >0.05 <0.05 <0.05
图4 经脐单孔腹腔镜手术后切口
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