摘要
目的探讨腹腔镜下卵巢畸胎瘤剥除术的临床应用及其对患者生育力的影响。方法将随访到的222例已婚有生育要求但未产未育的卵巢畸胎瘤患者分为腹腔镜组和开腹手术组。每组的手术方式分别为单侧畸胎瘤剥除术、双侧畸胎瘤剥除术、单侧附件切除术和单侧附件切除+对侧卵巢畸胎瘤剥除术。结果单侧畸胎瘤剥除术组,无论开腹手术还是腹腔镜下手术,其第一年的首次妊娠率、术后一年月经正常的比例、首次妊娠的活胎分娩率均分别高于双侧畸胎瘤剥除术组、单侧附件切除术组和单侧附件切除+对侧畸胎瘤剥除术组,而其首次妊娠的平均时间、首次妊娠的自然流产率却低于其它各组。单侧畸胎瘤剥除术组患者的各项生育力指标与其它各组相比较,除术后一年月经正常比例的部分数据外(见表),其余差异均具有显著(P<0.05)或极显著(P<0.01)意义。在单侧畸胎瘤剥除术组中,腹腔镜下手术其第一年的首次妊娠率、术后一年月经正常的比例、首次妊娠的活胎分娩率均高于开腹手术,但组间差异无统计学意义。而首次妊娠的平均时间、首次妊娠的自然流产率均低于开腹手术,但组间差异也无统计学意义。结论腹腔镜下卵巢畸胎瘤剥除术对患者生育力的影响较小,是年轻患者有生育要求的理想手术方式。
Objective： Exploring clinical use of ovarian teratoma decollement under laparoscopy and its effect on patients＇ fertility. Methods ： 222 married patients with teratoma of ovary, who had desire to give birth and who had never given any birth, were divided into the laparoscopy group and the laparotomy group. Operations, including unilateral teratomy decollement, bilateral teratomy decollement, unilateral adnexectomy, and unilateral adnexectomy plus contralateral ovarian teratoma decollement, were performed for each group respectively. Results： As regards the laparotomy and the operation under laparoscopy, their first pregnancy rate one year after the operation, the ratio of eumenorrhea one year after the operation, as well as the vital fetus delivering rate of the first pregnancy for the unilateral teratomy decollement group were higher than those for the bilateral teratomy decollement subgroup, unilateral adnexectomy subgroup, and unilateral adnexectomy plus contralateral ovarian teratoma decollement subgroup respectively. And however, their averaged time of the first pregnancy and natural abortion rate of the first pregnancy were lower than those for the other subgroups. In comparison with other subgroups, the difference of each of the fertility indices for the patients in the unilateral teratomy decollement group had statistical significance （ P 〈0. 05） or important statistical significance （ P 〈0. 01 ）, except for part of the data for the ratio of eumenorrhea one year after operations （ see attached tables） . As far as the operation under laparoscopy was concerned, the first pregnancy rate one year after the operation, the ratio of eumenorrhea one year after the operation, and the vital fetus delivering rate of the first pregnancy for the patients in the unilateral teratomy decollement group were 75.00%, 85.00% and 83.33% respectively, which were higher than those of 69. 5？%, 78. 26% and 81.25% for the laparotomy group. However, its averaged time of the first pregnancy and natural abortion rate of the first pregnancy were 6. 4 ± 2. 1 months and 16. 67% respectively, which were lower than those of 7. 2 ± 1.6 months and 18. 75% for the laparotomy group. The difference between the 2 groups had, however, no statistical significance. Conclusions： The ovarian teratoma decollement under laparoscopy had few effects on patients＇ fertility. Therefore, it is an ideal operation approach for young patients who have the desire to give birth.
出处
《中国优生与遗传杂志》
2010年第3期121-123,共3页
Chinese Journal of Birth Health & Heredity
关键词
腹腔镜
卵巢
畸胎瘤
生育力
手术
Laparoscopy
Ovarian
Teratoma
Fertility
Operation
