摘要
目的:探讨经脐单孔腹腔镜术(LESS)治疗子宫肌瘤效果及观察血清血红蛋白(Hb)、C反应蛋白(CRP)、降钙素原(PCT)水平变化。方法:回顾性选取2019年1月-2021年8月于兴化市人民医院行腹腔镜子宫肌瘤剔除术的120例子宫肌瘤患者作为研究对象,依据患者采用的不同手术方式,将其分为经脐LESS组(n=50)和多孔腹腔镜组(n=70)。对比两组患者围手术期指标[手术时间、术中出血量、术后首次肛门排气时间及住院时间]、切口美观满意度(CS)评分、疼痛视觉模拟评分法(VAS)评分、血清PCT、CRP和Hb水平,以及术后并发症发生率、月经正常率和复发率。结果:经脐LESS组患者术后首次肛门排气时间早于多孔腹腔镜组,住院时间短于多孔腹腔镜组(P<0.05),手术时间长于多孔腹腔镜组,CS评分高于对照组(P<0.05);术后6、12、24、72 h,LESS组疼痛VAS评分均低于多孔腹腔镜组(P<0.05);术后,经脐LESS组患者血清CRP、PCT水平均低于多孔腹腔镜组(P<0.05),Hb水平高于多孔腹腔镜组(P<0.05);随访6个月,两组复发率、并发症总发生率、月经正常率比较,差异均无统计学意义(P>0.05)。结论:与多孔腹腔镜手术比较,经脐LESS能明显减轻术后疼痛感,缩短住院时间,降低血清CRP、PCT水平,提高Hb水平,并提高术后切口美观度。
Objective:To explore the surgical effect of laparoendoscopic single site surgery(LESS)and changes of hemoglobin(Hb),C reactive protein(CRP),procalcitonin(PCT)levels in patients with uterine fibroids.Method:A total of 120 patients with uterine fibroids undergoing laparoscopic myomectomy in the Xinghua People’s Hospital from January 2019 to August 2021 were retrospectively enrolled as the research objects.According to different surgical methods,they were divided into transumbilical LESS group(n=50)and multiport laparoscopy group(n=70).The perioperative indexes[operating time,intraoperative bleeding,time to first postoperative anal discharge and length of hospital stay],score of incision cosmetic satisfaction(CS),scores of visual analogue scale(VAS),levels of serum PCT,CRP and Hb,incidence of complications during follow-up,normal menstruation rate and recurrence rate were compared between the two groups.Result:The postoperative first anal exhaust time in transumbilical LESS group was earlier than that in multiport laparoscopy group,hospitalization time in transumbilical LESS group was shorter than that in multiport laparoscopy group(P<0.05),operation time was longer than that in multiport laparoscopy group,and CS score was higher than that in multiport laparoscopy group(P<0.05).At 6,12,24 and 72 h after surgery,scores of pain VAS in transumbilical LESS group were lower than those in multiport laparoscopy group(P<0.05).After surgery,levels of serum CRP and PCT in transumbilical LESS group were lower than those in multiport laparoscopy group(P<0.05),and Hb level was higher than that in multiport laparoscopy group(P<0.05).During 6 months follow-up,there were no significant differences in recurrence rate,total incidence of complications and normal menstruation rate between the two groups(P>0.05).Conclusion:Compared with multiport laparoscopy,transumbilical LESS can significantly alleviate postoperative pain,shorten hospitalization time,reduce serum CRP and PCT,increase Hb and improve postoperative incision aesthetics.
作者
房倩倩
徐晓兰
翟翰芳
FANG Qianqian;XU Xiaolan;ZHAI Hanfang(Xinghua People’s Hospital,Jiangsu Province,Xinghua 225700,China;不详)
出处
《中国医学创新》
CAS
2022年第30期119-123,共5页
Medical Innovation of China
关键词
子宫肌瘤
经脐单孔腹腔镜手术
多孔腹腔镜手术
血红蛋白
C
反应蛋白
Uterine fibroid
Transumbilical laparoendoscopic single site surgery
Multiport laparoscopy
Hemoglobin
C reactive protein
