摘要
目的探讨自制入路通道的经脐单孔腹腔镜手术在妇科常见手术中的临床应用。方法回顾性收集2018年1月至2020年9月克拉玛依市中心医院成功开展的自制入路通道的经脐单孔腹腔镜手术105例,并选择条件匹配的多孔腹腔镜手术105例作对照。比较两组手术时间,术中失血量,术后首次排气时间,术后首次下床活动时间,术后24 h疼痛评分,术后3个月患者手术满意度评分,术后3个月医生对切口美容评分,术后住院时间,术中医生的感受评分及术中、术后并发症。结果所有手术均在腹腔镜下顺利完成,未中转为开腹手术,未加打辅助孔,术中未出现明显并发症。单孔腹腔镜组手术时间、术中出血量大于多孔腹腔镜组(均P<0.05)。单孔腹腔镜组切口美容评分明显优于多孔腹腔镜组(P<0.05)。多孔腹腔镜组术中医生感受评分优于单孔腹腔镜组(P<0.05)。两组术后首次排气时间、术后首次下床活动时间、术后24 h疼痛评分、患者手术满意度评分及术后住院时间比较,差异均无统计学意义(均P>0.05)。多孔腹腔镜组卵巢囊肿剥除术、子宫肌瘤剔除术、全子宫切除术手术时间及术中出血量小于单孔腹腔镜组(均P<0.05),两组输卵管切除术及附件切除术的手术时间及术中出血量比较,差异均无统计学意义(均P>0.05)。多孔腹腔镜组不同手术类型术中医生感受均优于单孔腹腔组(均P<0.05)。结论在病例选择合适的情况下,经脐单孔腹腔镜手术在妇科手术中是可行的,单孔腹腔镜突出的优点为术后美容效果。
Objective To explore the clinical application of transumbilical single-port laparoscopy with self-made approach in common gynecological operations.Methods 105 cases of transumbilical single-port laparoscopic surgery with self-made approach successfully(single-port laparoscopic group)carried out in Karamay Central Hospital from January 2018 to September 2020 were retrospectively collected,and 105 cases of multi-port laparoscopic surgery(multi-port laparoscopic group)with matching conditions were selected.The operation time,intraoperative blood loss,postoperative first exhaust time,postoperative first out of bed activity time,postoperative 24-h pain score,postoperative satisfaction score of patients 3 months after operation,incision cosmetic score of doctors 3 months after operation,postoperative hospital stay,intraoperative surgeon′s feeling score and intraoperative and postoperative complications were compared between the two groups.Results All operations were successfully completed under laparoscopy,without conversion to laparotomy,without auxiliary holes,and no obvious complications occurred during the operation.The operation time and intraoperative blood loss in the single-port laparoscopic group were greater than those in the multi-port laparoscopic group(all P<0.05).The incision cosmetic score of single-port laparoscopic group was significantly better than that of multi-port laparoscopic group(P<0.05).The intraoperative surgeon′s feeling score in multi-port laparoscopic group was better than that in single-port laparoscopic group(P<0.05).There was no significant difference between the two groups in the first postoperative exhaust time,the first postoperative out of bed activity time,24-hour postoperative pain score,surgical satisfaction score and postoperative hospital stay(all P>0.05).The operation time and intraoperative blood loss of ovarian cyst stripping,hysteromyomectomy and total hysterectomy in the multi-port laparoscopic group were less than those in the single-port laparoscopic group(all P<0.05
作者
贾小平
周静
马彩铃
Jia Xiaoping;Zhou Jing;Ma Cailing(Department of Gynecology,Karamay Central Hospital,Karamay 834000,China;Department of Gynecology,Xinjiang Medical University,Urumqi 830054,China)
出处
《中国医师杂志》
CAS
2022年第3期361-365,共5页
Journal of Chinese Physician
基金
新疆维吾尔自治区自然科学基金(2019D01A09)
克拉玛依市中心医院科技项目(YK2018-9)。
关键词
脐
腹腔镜检查
妇科外科手术
Umbilicus
Laparoscopy
Gynecologic surgical procedures
