CAJ | 학술논문

目的：探讨垂体后叶素联合10 mm自动子宫肌瘤旋切器在腹腔镜卵巢成熟性畸胎瘤剥除术中的应用价值。方法对我院2011年5月～2013年12月86例育龄期单侧卵巢成熟性畸胎瘤采用随机区组设计方案分成实验组和对照组。对照组采用常规剥除法，实验组将稀释的垂体后叶素（3 U＋0．9％生理盐水20 ml）注入卵巢囊肿壁与皮质间隙后再行剥除，剥离完全后将标本置入标本袋中用10 mm自动子宫肌瘤旋切器将标本旋出。比较2组出血量、手术时间、囊肿破裂率和术后2个月术侧残留卵巢体积。结果2组均在腹腔镜下顺利完成手术。实验组手术时间（40±26） min，明显短于对照组（58±25） min（t＝3．089，P＝0．003）；实验组术中出血量（39±16） ml，明显少于对照组（68±35） ml（t＝4．941，P＝0．000）；实验组囊肿破裂率14．0％（6／43），明显低于对照组34．9％（15／43）（χ2＝5．103，P＝0．024）。术后2个月实验组术侧残留卵巢体积（9．5±4．2） cm3，显著大于对照组手术侧残留卵巢体积（6．5±3．1） cm3（t＝3．769，P＝0．000）；实验组两侧卵巢体积缩小（2．4±1．1） cm3，显著小于对照组两侧卵巢体积的缩小值（4．2±1．8） cm3（t＝－5．595，P＝0．000）。结论腹腔镜下改良卵巢成熟性畸胎瘤剔除术能减少术中出血，降低囊肿破裂率，降低手术难度，减少对卵巢的影响，优于常规腹腔镜卵巢成熟性畸胎瘤剥除术。
목적：탐토수체후협소연합10 mm자동자궁기류선절기재복강경란소성숙성기태류박제술중적응용개치。방법대아원2011년5월～2013년12월86례육령기단측란소성숙성기태류채용수궤구조설계방안분성실험조화대조조。대조조채용상규박제법，실험조장희석적수체후협소（3 U＋0．9％생리염수20 ml）주입란소낭종벽여피질간극후재행박제，박리완전후장표본치입표본대중용10 mm자동자궁기류선절기장표본선출。비교2조출혈량、수술시간、낭종파렬솔화술후2개월술측잔류란소체적。결과2조균재복강경하순리완성수술。실험조수술시간（40±26） min，명현단우대조조（58±25） min（t＝3．089，P＝0．003）；실험조술중출혈량（39±16） ml，명현소우대조조（68±35） ml（t＝4．941，P＝0．000）；실험조낭종파렬솔14．0％（6／43），명현저우대조조34．9％（15／43）（χ2＝5．103，P＝0．024）。술후2개월실험조술측잔류란소체적（9．5±4．2） cm3，현저대우대조조수술측잔류란소체적（6．5±3．1） cm3（t＝3．769，P＝0．000）；실험조량측란소체적축소（2．4±1．1） cm3，현저소우대조조량측란소체적적축소치（4．2±1．8） cm3（t＝－5．595，P＝0．000）。결론복강경하개량란소성숙성기태류척제술능감소술중출혈，강저낭종파렬솔，강저수술난도，감소대란소적영향，우우상규복강경란소성숙성기태류박제술。
Objective To study the application value of pituitrin and morcellation in laparoscopic decollement for mature ovarian teratoma . Methods A total of 86 patients who were diagnosed as having unilateral mature teratoma of the ovary from May 2011 to December 2013 were randomly divided into either experiment group or control group .Pituitrin (3 U +0.9%NS 20 ml) were injected into the cavity between the mature teratoma and the cortex before the decollement and a morcellator knife was used to shatter teratoma in the experiment group , while the control group was given traditional decollement .The operation time, blood loss, rate of teratoma rupture , and ovarian volume were compared between the two groups . Results All of the operations were performed successfully under laparoscope .The operation time of the experiment group and control group was (40 ±26) min and (58 ±25) min (t=3.089, P=0.003), the blood loss was (39 ±16) ml and (68 ±35) ml (t=4.941, P=0.000), and the rate of teratoma rupture was 14.0%(6/43) and 34.9% (15/43) (χ2 =5.103, P=0.024), respectively.The residual volume of the ovary was significantly larger in the experiment group (9.5 ±4.2 cm3 ) than that in the control group (6.5 ±3.1 cm3 , t=3.769, P=0.000) two months after operation.The ovarian volumes were decreased by (2.4 ±1.1) cm3 and (4.2 ±1.8) cm3(t=-5.595,P=0.000) two months after operation . Conclusion Use of pituitrin and morcellation in laparoscopic decollement for mature teratoma of ovary leads to short operation time , less blood loss , low rate of teratoma rupture , and minimal influence of ovarian functions , being superior to regular laparoscopic decollement for mature ovarian teratoma .