[1]韩丽萍,金凤斌,张玲.悬吊式腹腔镜辅助治疗巨大卵巢囊肿[J].中国微创外科杂志,2012,12(2):121-123.
　Han Liping*,Jin Fengbin*,Zhang Ling..Gasless Laparoscopy for Giant Ovarian Cyst[J].Chinese Journal of Minimally Invasive Surgery,2012,12(2):121-123.
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悬吊式腹腔镜辅助治疗巨大卵巢囊肿()
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《中国微创外科杂志》[ISSN:1009-6604/CN:11-4526/R]

卷:
12
期数:
2012年2期
页码:
121-123
栏目:
出版日期:
2012-02-25

文章信息/Info

Title:
Gasless Laparoscopy for Giant Ovarian Cyst
作者:
韩丽萍; 金凤斌; 张玲
辽宁省锦州市妇婴医院妇科，锦州121000
Author(s):
Han Liping*;  Jin Fengbin*;  Zhang Ling.
*Department of Gynecology, Jinzhou Maternal and Infant Hospital, Jinzhou 121000, China
关键词:
悬吊式腹腔镜手术; 巨大卵巢囊肿
Keywords:
Gasless laparoscopy; Giant ovarian cyst
分类号:
R737.31
文献标志码:
A
摘要:
目的探讨悬吊式腹腔镜辅助手术在巨大卵巢囊肿治疗中的临床应用价值。方法2006年1月~2009年12月对89例巨大卵巢囊肿（囊肿直径≥10 cm)分别采用悬吊式腹腔镜、气腹腹腔镜、开腹手术3种不同方式进行治疗，比较3种术式在手术时间、术中出血量、术后排气时间、术后疼痛、皮下气肿及血肿发生率、住院时间等方面的差异,术后随访3个月观察月经情况。结果3组手术时间、术中出血量、术后疼痛、排气时间、住院时间均有显著性差异（P＜0.05）。3组术中并发症及皮下气肿、血肿发生率无明显差异(P>0.05)。悬吊组手术时间（38.4±10.5）min显著短于气腹组（110.5±12.2）min（q=30.758,P<0.05）和开腹组手术时间(65.3±14.6)min(q=11.566,P<0.05)；悬吊组术中出血量（40.3±12.8）ml明显少于气腹组（150.8±30.2）ml（q=26.598，P<0.05）及开腹组（95.7±20.1）ml（q=13.440，P<0.05）；悬吊组术后排气时间（144±4.3）h明显短于气腹组（24.9±5.9）h（q=10.157，P<0.05）及开腹组(50.8±6.2)h（q=35.490,P<0.05）；悬吊组住院时间（3.2±0.8）d明显少于开腹组（6.7±0.7）d（q=18.681,P<0.05）。悬吊组肩胛疼痛2例（7.1%），明显少于气腹组10例（33.3%）（χ2=6.054，P=0.014）；悬吊组皮下气肿发生率0，明显低于气腹组6例（20.0%）（Fisher’s检验，P=0.015）；悬吊组术后腹壁疼痛5例（17.8%），明显低于开腹组26例（83.9%）（χ2=25.711，P=0.000）。术后3个月气腹组月经异常发生率为13.4%（4/30），悬吊组及开腹组分别为3.6%（1/28）和6.4%（2/31），3组比较无显著性差异（χ2=2.036,P=0.361）。结论悬吊式腹腔镜辅助治疗巨大卵巢囊肿优于气腹腹腔镜手术和传统开腹手术。
Abstract:
ObjectiveTo access gasless laparoscopic operation for large ovarian cysts. MethodsFrom January 2006 to December 2009, 89 patients with giant ovarian cyst (≥10 cm in diameter) received gasless laparoscopy, pneumoperitoneum laparoscopy, or open surgery respective in our hospital. The operation time, intraoperative blood loss, postoperative gastrointestinal function recovery time, rate of postoperative pain, and hospital stay were compared among the three groups. The patients were followed up for three months to observe menstruation.ResultsSignificant difference existed in the operation time, intraoperative blood loss, postoperative pain, gastrointestinal function recovery time, and hospital stay (P＜0.05) among the three groups, but not in the rates of subcutaneous emphysema and hematoma (P>0.05). The gasless group showed significantly shorter operation time, less intraoperative blood loss, and shorter gastrointestinal function recovery time than both the pneumoperitoneum and open groups ［(38.4±10.5) min vs. (110.5±12.2) min (q=30.758, P<0.05) and (65.3±14.6) min (q=11.566, P<0.05); (40.3±12.8) ml vs. (150.8±30.2) ml (q=26.598, P<0.05) and (95.7±20.1) ml (q=13.440, P<0.05); (14.4±4.3) h vs. (24.9±5.9) h (q=10.157, P<0.05) and (50.8±6.2)h (q=35.490, P<0.05)］; shorter hospital stay than the open group ［(3.2±0.8) d vs. (6.7±0.7) d, q=18.681, P<0.05)］; lower rates of shoulder pain and subcutaneous emphysema then the pneumoperitoneum group ［2 cases (7.1%) vs. 10 cases (33.3%), χ2=6.054, P=0.014); 0 vs. 6 cases (20.0%), Fisher’s test P=0.015］; and lower rate of abdominal pain than the open group ［5 cases (17.8%) vs. 26 cases (83.9%), χ2=25.711, P=0.000］. The rate of abnormal menstruation in three months was 13.4% (4/30), 3.6% (1/28), and 6.4% (2/31) in pneumoperitoneum, gasless, and open groups respectively (χ2=2.036, P=0.361). ConclusionGasless laparoscopic operation is superior to pneumoperitoneum laparoscopy and open surgery in the treatment of large ovarian cysts.

参考文献/References:

[1]李光仪，主编.实用妇科腹腔镜手术学.北京：人民卫生出版社,2006.204.
[2]龙雯晴，焦海宁，喇端端，等.腹腔镜卵巢囊肿剔除术对卵巢功能的影响.中国微创外科杂志,2010,10(10):902-907.
[3]赖婷，刘赛欧，吴蓓，等.腹腔镜采用高频电刀用于卵巢止血对卵巢功能的近期影响.贵州医药,2005,29(5):406-408.
[4]Barwijuk AJ，Paplicki A．Gasless laparoscopic eysteetomy due to ovarian cyst torsion in 14 weeks pregnant patient．Ginekol Pol，2005，76(11)：906-907.
[5]Phupong V，Bunyavejchewin S．Gasless laparoscopic surgery for ovarian cyst in a second trimester pregnant patient with a ventrieular septal defect．Surg Laparosc Endosc Percutan Tech，2007，17(6)：565-566.

备注/Memo

备注/Memo:
张玲（辽宁省盘锦市大洼县医院妇产科，大洼124200）
更新日期/Last Update: 2013-04-11