【摘要】 目的探讨改良经脐单孔腹腔镜治疗子宫肌瘤效果及对术后疼痛的影响。方法回顾性分析2017年1月—2018年3月本院收治的96例拟行腹腔镜子宫肌瘤剔除术的子宫肌瘤患者的临床资料,根据摸球法将患者随机分为改良单孔组与多孔组两组,每组各48例。改良单孔组采用改良经脐单孔腹腔镜子宫肌瘤剔除术治疗,多孔组采用传统三孔腹腔镜子宫肌瘤剔除术,对比两组术中出血量、术后住院时间、手术时间、首次排气时间、引流管拔除时间、首次下床时间,比较两组术后6 h、术后12 h视觉模拟评分(VAS),随访2年,记录两组妊娠率及复发率。结果改良单孔组手术时间、术后住院时间、引流管拔除时间比多孔组短(P<0.05),且术中出血量比多孔组低(P<0.05),两组首次下床时间及首次排气时间对比无显著性差异(P>0.05);改良单孔组术后6 h、12 h VAS评分比多孔组低(P<0.05);两组并发症总发生率相近(6.25%vs.10.42%,P>0.05);改良单孔组与多孔组妊娠率(29.17%vs.27.08%)及复发率(2.08%vs.6.25%)相近(P>0.05)。结论改良经脐单孔腹腔镜子宫肌瘤剔除术用于治疗子宫肌瘤患者,手术效果显著,可减轻患者术后疼痛、缩短手术时间、降低术中出血量,并且不影响妊娠率及复发率,且安全可靠。更多还原

【Abstract】 Objective To explore the effect of modified trans-umbilical single port laparoscopy in the treatment of uterine fibroids and its influence on postoperative pain.Methods A total of 96 patients with uterine fibroids who were to undergo laparoscopic myomectomy, who were admitted to people’s hospital of Taihe county from January 2017 to March 2018,were selected as the research objects, and the patients were randomly divided into modified single port group and porous group according to the ball touch method, 48 cases in each group.The modified single port group was treated with modified trans-umbilical single port laparoscopic myomectomy, and the porous group was treated with traditional three port laparoscopic myomectomy. The intraoperative blood loss,postoperative hospital stay,operation time,and first exhaust time,drainage tube removal time,and time to get out of bed for the first time were compared.The scores of visual analogue scale( VAS) at 6 h and 12 h after the operation were compared between the two groups; The patients were followed up for 2 years,and the pregnancy rate and recurrence rate of the two groups were recorded. Results The operation time,postoperative hospital stay and drainage tube removal time in the modified single port group were shorter than those in the porous group( P < 0.05),and the intraoperative blood loss was lower than that in the porous group( P<0.05).There were no significant difference in the first exhaust time and time to get out of bed for the first time( P>0.05); the modified single port group had lower VAS scores at 6 h and 12 h after surgery than the porous group( P < 0. 05); the total incidence of complications in the two groups was similar( 6. 25% vs. 10. 42%,P > 0. 05); the pregnancy rate( 29. 17% vs. 27.08%) and recurrence rate( 2.08% vs.6.25%) of the modified single port group and the porous group were similar( P> 0.05).Conclusions Modified trans-umbilical single-port laparoscopic myomectomy performs significant surgical effect in treating patients with uterine fibroids,it could reduce postoperative pain,shorten the operation time,reduce intraoperative blood loss,and does not affect the pregnancy rate and recurrence rate,and it is safe and reliable.更多还原