摘要： 目的 探讨经脐单孔腹腔镜套扎法在子宫肌壁间肌瘤切除术的临床应用。方法 选取2018年12月至2021年12月我院实施单孔腹腔镜套扎法子宫肌壁间肌瘤切除术的30例患者作为研究组,选取同期多孔腹腔镜套扎法子宫肌壁间肌瘤切除术的30例患者作为对照组,记录并比较2组患者手术时间、术中出血量、术前及术后2 d血红蛋白差值、术后排气时间、住院时间、切口美容满意度、术后24 h视觉模拟评分(VAS)、术后24 h肩部疼痛发生率、术后并发症发生情况。结果 与对照组比较,研究组手术时间延长;切口美容满意度增高;术后24 h VAS评分降低;术后24 h肩部疼痛发生率减少;术前及术后2 d血红蛋白差值增加,差异均有统计学意义(均P <0.05)。而2组患者术中出血量、术后排气时间、住院时间比较差异均无统计学意义(均P>0.05)。2组均未出现并发症。研究组无中转多孔或开腹手术,对照组无中转开腹手术。结论 与多孔腹腔镜套扎法比较,经脐单孔腹腔镜套扎法应用于子宫肌壁间肌瘤切除术时手术时间较长,手术切口美容满意度更高,术后疼痛减轻、术后24 h肩部疼痛发生率更低。经脐单孔腹腔镜套扎法应用于子宫肌壁间肌瘤切除术安全可行,值得临床上推广应用。

经脐单孔腹腔镜套扎法在子宫肌壁间肌瘤切除术中的应用

崔茹婷, 赵福杰

中国医科大学附属盛京医院妇产科, 沈阳 110004

收稿日期:2021-11-12出版日期:2022-07-30发布日期:2022-06-27
通讯作者:赵福杰E-mail:zhaofujie63@163.com
作者简介:崔茹婷(1989-),女,医师,硕士.



关键词: 单孔腹腔镜, 套扎法, 子宫肌瘤切除术
Abstract: Objective To compare the clinical application of single-port laparoscopic ligation via umbilicus on intramural myomectomy of uterus. Methods A total of 30 patients who underwent intramural myomectomy of uterus using single-port laparoscopic ligation via umbilicus from December 2018 to December 2021 in Shengjing Hospital were selected as the experiment group; another 30 patients who underwent intramural myomectomy of uterus by porous laparoscopic ligation,simultaneously,were included in the control group. The operative duration,intraoperative bleeding,preoperative and postoperative 2-day hemoglobin difference,time of exsufflation,length of stay (LOS),incision cosmetic results,24-hour postoperative visual analogue scale (VAS),24-hour postoperative incidence of shoulder pain, and incidence of postoperative complications were compared between both the groups. Results Relative to control group,in the experiment group,the operative duration was prolonged,satisfaction with incision improved,VAS score declined,and incidence of shoulder pain decreased, and postoperative 2-day hemoglobin difference increased (all P< 0.05). However,the difference in the rest of the indexes fell short of statistical significance (all P> 0.05). There were no complications and cases operated after invalidation in conservative treatment in both groups. Conclusion Compared with porous laparoscopic ligation,intramural myomectomy of the uterus using single-port laparoscopic ligation via the umbilicus improved satisfaction with incision,decreased postoperative pain and incidence of shoulder pain,and prolonged operative duration. Single-port laparoscopic ligation via umbilicus on intramural myomectomy of uterus is safe and effective,and has more clinical applications in future.
Key words: single-port laparoscopy, loop ligation technique, myomectomy
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