摘要
目的探讨经脐单切口三通道腹腔镜治疗老年卵巢囊肿的效果和安全性。方法选取2019年5月—2021年5月收治的老年卵巢囊肿59例,按治疗方式不同分为观察组30例和对照组29例。观察组行经脐单切口三通道腹腔镜附件切除术,对照组行传统多孔腹腔镜附件切除术。比较两组围术期指标、术后疼痛程度、心肺功能、应激反应和炎性指标的变化。结果观察组手术时间、术后下床时间、术后排气时间、住院时间均短于对照组,住院费用低于对照组,切口美观满意度高于对照组(P<0.05)。观察组术后不同时间点疼痛视觉模拟评分法评分均低于对照组(P<0.05)。术后1、3 d,两组皮质醇、血糖、白细胞介素-6、肿瘤坏死因子-α、超敏C反应蛋白水平均高于术前,但观察组低于对照组(P<0.05)。术后7 d,观察组心率低于对照组,动脉血氧分压、第1秒用力呼气容积、左心室射血分数、每搏输出量均明显高于对照组(P<0.05)。观察组术后并发症总发生率低于对照组(P<0.05)。结论经脐单切口三通道腹腔镜治疗老年卵巢囊肿效果显著优于传统多孔腹腔镜,能改善应激反应和炎性因子,且安全性高。
Objective To investigate the efficacy and safety of transumbilical single-incision and three-port laparoscopy in treatment of elderly patients with ovarian cysts.Methods A total of 59 elderly patients with ovarian cysts admitted between May 2019 and May 2021 were selected and divided into observation group(n=30)and control group(n=29)according to different therapeutic methods.Observation group received single-incision and three-port laparoscopic adnexectomy,while control group received conventional porous laparoscopic adnexectomy.Changes of perioperative indexes,postoperative pain degree,cardiopulmonary function,stress reaction and inflammatory indexes were compared between two groups.Results Compared with those in control group,operative duration,postoperative time of off-bed activity,postoperative exhaust time and length of hospitalization were shorter,and hospitalization expenses was less,while aesthetic satisfaction of incision was better in observation group(P<0.05).Visual analogue scale pain scores in observation group were lower than those in control group at different postoperative times(P<0.05).After operation for 1 d and 3 d,levels of cortisol,blood glucose,interleukin-6,tumor necrosis factor-αand hypersensitive C-reactive protein were higher than those before operation in two groups,but the levels in observation group were lower than those in control group(P<0.05).After operation for 7 d in observation group,heart rate was significantly lower,while levels of arterial blood oxygen partial pressure,forced expiratory volume in the first second,left ventricular ejection fraction and stroke volume were significantly lower than those in control group(P<0.05).The total incidence rate of postoperative complications in observation group was significantly lower than that in control group(P<0.05).Conclusion The efficacy of transumbilical single-incision and three-port laparoscopy in treatment of elderly patients with ovarian cyst is significantly better than that by traditional multi-port laparoscopy,which may improve the stress reaction and inflammatory factors with good safety.
作者
李苓妙
王海波
李萍
胡晓丽
武子先
甄银芝
杨俊红
LI Ling-miao;WANG Hai-bo;LI Ping;HU Xiao-li;WU Zi-xian;ZHEN Yin-zhi;YANG Jun-hong(Department of Obstetrics and Gynecology,School of Non-commissioned Officer,PLA Army Military Medical University,Shijiazhuang 050041,China)
出处
《临床误诊误治》
CAS
2022年第6期97-101,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省卫生和健康委员会重点基金资助项目(冀卫办科教[2021]20210604号)。
