中国综合临床
中國綜閤臨床
중국종합림상
CLINICAL MEDICINE OF CHINA
2014年
7期
767-770
,共4页
卵巢良性囊肿%腹腔镜手术%开腹手术%阴式手术%手术剥除
卵巢良性囊腫%腹腔鏡手術%開腹手術%陰式手術%手術剝除
란소량성낭종%복강경수술%개복수술%음식수술%수술박제
Benign ovarian neoplasm%Laparoscopic operation%Abdominal operation%Transvaginal operation%Stripping operation
目的：比较采用阴式途径、腹腔镜以及腹式不同术式行卵巢囊肿剥除术治疗卵巢良性囊肿的临床效果，总结阴式途径术式的特点。方法2006年1月至2012年12月来我院治疗的卵巢良性囊肿患者226例，其中75例行经阴道手术（阴式组），77例行腹腔镜下手术（腹腔镜组），74例行开腹手术（腹式组）。观察比较3组的手术时间、术中出血量、术后镇痛病例、术后排气时间和住院天数，以及术后病率。随访时间为术后1、3个月，进行临床疗效评定。结果术中手术时间和出血量阴式组[（41.71±16.92）min、（33.11±20.19）ml]与腹腔镜组[（50.73±18.71）min、（38.21±18.73）ml]和腹式组[（61.81±19.75）min、（107.29±41.27）ml]相比最少；术后排气时间（12.19±4.17）h 较腹腔镜组（15.43±4.31）h、腹式组（30.00±6.21）h 短；住院时间阴式组[（4.38±1.30）d 较腹腔镜组（5.60±0.50）d、腹式组（8.50±2.00）d]短，差异有统计学意义（P ＜0.05或 P ＜0.01）；术后病率阴式组1.33％、腹腔镜组1.30％较腹式组（4.05％）低，差异有统计学意义（P =0.036）。随访到3个月，3组有效率[阴式组94.7％（71/75）、腹腔镜组94.8％（73/77）、腹式组94.6％（70/74）]比较差异无统计学意义（P ＞0.05）。结论经阴道手术和腹腔镜手术治疗卵巢良性囊肿各有利弊，临床应用要准确掌握手术指征，以最小的创伤达到最佳治疗效果。
目的：比較採用陰式途徑、腹腔鏡以及腹式不同術式行卵巢囊腫剝除術治療卵巢良性囊腫的臨床效果，總結陰式途徑術式的特點。方法2006年1月至2012年12月來我院治療的卵巢良性囊腫患者226例，其中75例行經陰道手術（陰式組），77例行腹腔鏡下手術（腹腔鏡組），74例行開腹手術（腹式組）。觀察比較3組的手術時間、術中齣血量、術後鎮痛病例、術後排氣時間和住院天數，以及術後病率。隨訪時間為術後1、3箇月，進行臨床療效評定。結果術中手術時間和齣血量陰式組[（41.71±16.92）min、（33.11±20.19）ml]與腹腔鏡組[（50.73±18.71）min、（38.21±18.73）ml]和腹式組[（61.81±19.75）min、（107.29±41.27）ml]相比最少；術後排氣時間（12.19±4.17）h 較腹腔鏡組（15.43±4.31）h、腹式組（30.00±6.21）h 短；住院時間陰式組[（4.38±1.30）d 較腹腔鏡組（5.60±0.50）d、腹式組（8.50±2.00）d]短，差異有統計學意義（P ＜0.05或 P ＜0.01）；術後病率陰式組1.33％、腹腔鏡組1.30％較腹式組（4.05％）低，差異有統計學意義（P =0.036）。隨訪到3箇月，3組有效率[陰式組94.7％（71/75）、腹腔鏡組94.8％（73/77）、腹式組94.6％（70/74）]比較差異無統計學意義（P ＞0.05）。結論經陰道手術和腹腔鏡手術治療卵巢良性囊腫各有利弊，臨床應用要準確掌握手術指徵，以最小的創傷達到最佳治療效果。
목적：비교채용음식도경、복강경이급복식불동술식행란소낭종박제술치료란소량성낭종적림상효과，총결음식도경술식적특점。방법2006년1월지2012년12월래아원치료적란소량성낭종환자226례，기중75례행경음도수술（음식조），77례행복강경하수술（복강경조），74례행개복수술（복식조）。관찰비교3조적수술시간、술중출혈량、술후진통병례、술후배기시간화주원천수，이급술후병솔。수방시간위술후1、3개월，진행림상료효평정。결과술중수술시간화출혈량음식조[（41.71±16.92）min、（33.11±20.19）ml]여복강경조[（50.73±18.71）min、（38.21±18.73）ml]화복식조[（61.81±19.75）min、（107.29±41.27）ml]상비최소；술후배기시간（12.19±4.17）h 교복강경조（15.43±4.31）h、복식조（30.00±6.21）h 단；주원시간음식조[（4.38±1.30）d 교복강경조（5.60±0.50）d、복식조（8.50±2.00）d]단，차이유통계학의의（P ＜0.05혹 P ＜0.01）；술후병솔음식조1.33％、복강경조1.30％교복식조（4.05％）저，차이유통계학의의（P =0.036）。수방도3개월，3조유효솔[음식조94.7％（71/75）、복강경조94.8％（73/77）、복식조94.6％（70/74）]비교차이무통계학의의（P ＞0.05）。결론경음도수술화복강경수술치료란소량성낭종각유리폐，림상응용요준학장악수술지정，이최소적창상체도최가치료효과。
Objective To investigate the clinical effect of abdominal operation,laparoscopic operation and vaginal operation on treating ovarian cysts in order to summarize the characteristics of Yin type way operation. Methods Two hundreds and twenty-six patients with benign ovarian cysts were selected as our subjects and they were hospitalized from Jan. 2006 to Dec. 2012 in the First People's Hospital of Shangqiu. Of 226 patients,there were 77 cases with laparoscopic operation( laparoscopic group),75 cases with vaginal operation(transvaginal group),and 74 cases with traditional open operation(abdominal group). The information of operation periods,intraoperative blood loss volum,postoperative analgesia,postoperative exhaust time and hospitalization days,and the rate of postoperative complication were collected. All the patients were followed-up at 1 or 3 months after surgery. Results Operation periods and bleeding volume in vaginal group was(41. 71 ± 16. 92)min and(33. 11 ± 20. 19)ml,less than that in laparoscopic((50. 73 ± 18. 71)min,(38. 21 ± 18. 73)ml)and abdominal group((61. 81 ± 19. 75)min.(107. 29 ± 41. 27)ml)and the difference was significant. Meanwhile,gastrointestinal function recovery in vaginal group was(12. 19 ± 4. 17)h,less than that other two groups(15. 43 ± 4. 31)h and(30. 00 ± 6. 21)h). In addition,shorter hospitalization period was also less than that of other two groups((4. 38 ± 1. 30)d vs.(5. 60 ± 0. 50)d vs.(8. 50 ± 2. 00)d;P < 0. 05 or P< 0. 01). The rate of postoperative complication of laparoscopic group was 1. 30% ,and 1. 33% for transvaginal group and 4. 05% for abdominal group,and the difference was significant( P = 0. 036). After followed-up 3 months,the clinical effect of transvaginal group was 94. 7% ,94. 8% for laparoscopic group and 94. 6%(70 / 74) for abdominal group,and the difference was not significant( P > 0. 05 ). Conclusion The approaches of transvaginal operation and laparoscopy operation treating the ovarian cyst have their advantages and disadvantages. It is better to accurately understand the operation indications and then achieve the best therapeutic effect with minimal trauma.
