单孔腹腔镜手术对治疗卵巢囊肿患者的手术相关指标、术后炎症反应及卵巢储备功能的影响

Effect of single-port laparoscopic surgery on surgery-related indicators,postoperative inflammatory response and ovarian reserve function in patients with ovarian cysts

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摘要目的:探讨单孔腹腔镜手术对治疗卵巢囊肿患者的手术相关指标、术后炎症反应及卵巢储备功能的影响。方法:选取91例卵巢囊肿患者为研究对象,按照手术方式不同分为单孔组(n=45)和传统组(n=46)。单孔组患者行经脐单孔腹腔镜卵巢囊肿剔除术;传统组患者行传统腹腔镜卵巢囊肿剥离术。比较两组患者手术相关指标[手术时间、术中出血量、术后首次排气时间、术后24 h疼痛情况(VAS评分)、首次下床活动时间、术后住院时间];术前及术后1 d炎症反应[C-反应蛋白(CRP)及白细胞介素6(IL-6)水平];术前及术后1个月、3个月卵巢储备功能[窦卵泡数(AFC)及抗米勒管激素检查(AMH)];术中及术后不良反应发生情况。结果:相较于传统组,单孔组患者术中出血量较多(P<0.05);术后24 h VAS评分更低(P<0.05);术后首次排气、首次下床活动及术后住院时间更短(P<0.05)。术后1 d,两组患者CRP及IL-6水平均升高(P<0.05),但单孔组低于对照组(P<0.05)。术后1个月,两组患者AFC及AMH均降低(P<0.05),但组间差异无统计学意义(P>0.05);术后3个月,两组患者AFC及AMH均基本恢复至术前水平(P<0.05),但组间差异无统计学意义(P>0.05)。单孔组患者术中囊肿破裂率高于传统组(P<0.05);术后不良反应总发生率低于传统组(P<0.05)。结论:单孔和传统腹腔镜均对卵巢囊肿有较好的疗效,但单孔腹腔镜患者术后恢复更快,术后炎症反应更低、术后总不良反应发生更少,且对卵巢储备功能的影响与传统腹腔镜相当。 Objective:To investigate the effect of single-port laparoscopic surgery on surgical related indicators,postoperative inflammatory response and ovarian reserve function in patients with ovarian cysts.Methods:The clinical data of 91 patients with ovarian cysts were retrospectively analyzed.According to the different surgical methods,they were divided into single-port group(n=45)and traditional group(n=46).Patients in the single-port group underwent transumbilical single orifice laparoscopic ovarian cyst removal surgery,and patients in the traditional group underwent traditional laparoscopic ovarian cyst dissection surgery.The clinical efficacy,operation-related indicators[operation time,intraoperative blood loss,postoperative first exhaust time,postoperative 24 h pain(VAS scores),first ambulation time,postoperative hospital stay],inflammatory response[C-reactive protein(CRP)and interleukin-6(IL-6)]before operation and 1 day after operation,ovarian reserve function[antral follicle count(AFC)and anti-Müllerian hormone(AMH)]before operation,1 and 3 months after operation were compared between the two groups,and adverse reactions were compared between the two groups.Results:Compared with the traditional group,the single-port group had less intraoperative blood loss(P<0.05),lower VAS score at 24 h after operation(P<0.05),and shorter postoperative first exhaust,first ambulation and postoperative hospital stay(P<0.05).1 day after operation,the levels of inflammatory factors CRP and IL-6 in the two groups increased(P<0.05),and the single-port group was lower than the traditional group(P<0.05).1 month after operation,AFC and AMH in the two groups were lower than those before operation(P<0.05),and there was no significant difference between the two groups(P>0.05).At 3 months after operation,AFC and AMH in both groups basically returned to preoperative levels(P<0.05),but there was no statistically significant difference between the groups(P>0.05).The rate of cyst rupture in the single-port group was lower than that in the tr

作者孙瑞清赵航张巧愉李玉萍 SUN Rui-qing;ZHAO Hang;ZHANG Qiao-yu;LI Yu-ping(Department of Gynecology,the 73rd Group Army Hospital of the People s Liberation Army of China,Xiamen 361000,Fujian,China)

机构地区中国人民解放军陆军第七十三集团军医院妇科

出处《川北医学院学报》 CAS 2024年第5期660-664,共5页 Journal of North Sichuan Medical College

基金福建省厦门市医疗卫生指导项目(3502Z202009163)。

关键词卵巢囊肿单孔腹腔镜传统腹腔镜疗效炎症反应卵巢储备功能 Ovarian cyst Single-port laparoscopy Traditional laparoscopy Curative effect Inflammatory reaction Ovarian reserve function

分类号 R737.31 [医药卫生—肿瘤]