经阴道单孔腹腔镜治疗对卵巢良性肿瘤患者卵巢功能影响的临床研究
| 作者: |
1李境,
1何满珠,
1侯涛
1 梅州市人民医院妇一科，广东 梅州 514700 |
| 通讯: |
李境
Email: gdmzlijing@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.11.019 |
| 基金: | 梅州市人民医院科研培育项目(PY-C2021005)。 |
摘要
目的：探讨经阴道单孔腹腔镜治疗对卵巢良性肿瘤患者卵巢功能的影响。方法：选取2017年1月至2021年1月于梅州市人民医院行腹腔镜手术治疗的卵巢良性肿瘤患者80例，根据手术方式分为观察组与对照组，每组各40例。对照组采取传统多孔腹腔镜手术治疗，观察组采用经阴道单孔腹腔镜卵巢肿瘤剔除术治疗，比较两组患者手术时间、术中出血量、术后疼痛、术后首次下床和住院时间情况，观察两组患者术前、术后卵巢功能变化。结果：观察组患者手术时间、术中出血量、术后首次下床时间、住院时间均显著优于对照组(P<0.05)；对照组术后增加镇痛药物患者比率显著高于观察组(P<0.05)；两组患者术后疼痛视觉模拟评分(Visual Analogue Scale，VAS)随着术后时间延长呈明显降低趋势(P<0.05)，观察组术后1 d的VAS显著低于对照组(P<0.05)；两组患者术后4周卵巢基质收缩期峰值流速(peak systolic velocity，PSV)、阻力指数(resistant index，RI)均显著低于术前(P<0.05)，观察组术后4周的PSV、RI、搏动指数(pulsatility index，PI)均显著高于对照组(P<0.05)；两组患者术后4周窦卵泡数目(antral follicles count，AFC)、雌二醇(estradiol，E2)水平均显著低于术前(P<0.05)，而促卵泡生成素(follicle-stimulating hormone，FSH)水平均显著高于术前(P<0.05)；观察组术后4周的AFC、E2水平显著高于对照组(P<0.05)，而促黄体生成素(luteinizing hormone，LH)、FSH水平均显著低于对照组(P<0.05)；两组患者均未出现严重并发症。结论：经阴道单孔腹腔镜卵巢肿瘤剔除术治疗可有效减轻卵巢良性肿瘤患者术后疼痛并缩短术后下床时间，对患者卵巢功能影响较小。
关键词：
卵巢良性肿瘤；单孔腹腔镜；经阴道；卵巢功能
Clinical study on the effects of transvaginal single-port laparoscopy on ovarian function in patients with benign ovarian tumors
CorrespondingAuthor: LI Jing Email: gdmzlijing@163.com
DOI: 10.3978/j.issn.2095-6959.2021.11.019
Foundation: This work was supported by the Research and Cultivation Project in Meizhou People’s Hospital, China (PY-C2021005).
Abstract
Objective: To explore the effects of transvaginal single-port laparoscopy on ovarian function in patients with benign ovarian tumors. Methods: A total of 80 patients with benign ovarian tumors who underwent laparoscopy in the hospital from January 2017 to January 2021 were enrolled. According to different surgical methods, they were divided into observation group and control group, 40 cases in each group. The control group underwent traditional multi-port laparoscopy, while the observation group underwent transvaginal single-port laparoscopy. The operation time, intraoperative blood loss, postoperative pain, the first leaving bed time after surgery and hospitalization time were compared between the 2 groups. Changes of ovarian function before and after surgery in both groups were observed. Results: The operation time, intraoperative blood loss, the first leaving bed time after surgery and hospitalization time were significantly lower in the observation group than the control group (P<0.05), and proportion of cases increasing analgesics was significantly higher in the control group (P<0.05). The scores of Visual Analogue Scale (VAS) were significantly decreased as time in both groups (P<0.05). VAS score at 1d after surgery in the observation group was significantly lower than that in the control group (P<0.05). At 4 weeks after surgery, peak systolic velocity (PSV) and resistance index (RI) of ovarian stroma were significantly lower than those before surgery in both groups (P<0.05), and PSV, RI and pulsatility index (PI) in the observation group were significantly higher than those in the control group (P<0.05). At 4 weeks after surgery, antral follicles count (AFC) and estradiol (E2) were significantly lower than those before surgery in both groups (P<0.05), while level of follicle-stimulating hormone (FSH) was significantly higher than that before surgery (P<0.05). AFC and E2 levels in the observation group were significantly higher than those in the control group (P<0.05), while levels of luteinizing hormone (LH) and FSH were significantly lower than those in the control group (P<0.05). There were no severe complications in either group. Conclusion: Transvaginal single-port laparoscopy for ovarian tumor can effectively relieve postoperative pain and shorten leaving bed time after surgery in patients with benign ovarian tumors, with few effects on ovarian function.
Keywords：
benign ovarian tumor; single-port laparoscope; transvaginal; ovarian function