超声介入与腹腔镜下治疗卵巢囊肿蒂扭转的疗效对比

【目的】评价超声介入穿刺硬化治疗与腹腔镜下手术治疗卵巢囊肿蒂扭转的临床疗效和应用价值。【方法】79例卵巢囊肿蒂扭转的患者分别接受超声介入穿刺硬化治疗(介入组,35例)和腹腔镜手术治疗(腔镜组,44例)。对两组的治疗效果、手术时间、治疗费用、不良反应及复发率等指标进行比较。【结果】介入组手术时间(33.06±11.09)min,医疗费用(2177.23±221.65)元,不良反应2例,1年后复发1例;腔镜组手术时间(57.41±20.05)min,医疗费用(4308.09±322.62)元,出现不良反应16例,1年后复发1例;介入组8例合并妊娠者均正常分娩,腔镜组9例合并妊娠者7例终止妊娠,2例正常分娩。介入组不仅治疗时间短、医疗费用低,且不良反应发生率也明显低于腔镜组(P<0.01),而两组复发率差异无统计学意义(P>0.05)。【结论】两种方法均能有效治疗卵巢囊肿蒂扭转。腹腔镜手术适应症广,已被广泛使用。超声介入方法简捷、创伤更小且费用低廉,具有一定的优势,适合基层单位应用。

Comparative analysis of ultrasound interventional and laparoscopic treatment of ovarian cyst torsion

[Objective]To compare the efficacy of ultrasound interventional puncture sclerotherapy and laparoscopic surgery on the treatment of ovarian cyst torsion. [MethodslA total of 79 patients with ovarian cyst torsion were allocated into ultrasound interventional puncture sclerotherapy group（intervention group, 35 patients） and laparoscopic surgery group（laparoscopy group, 44 patients） respectively. Clinical efficacy, procedure time, adverse reactions, costs and relapse rates were compared. [ Results]Both methods were effective for the treatment of ovarian cyst torsion with low complication rates. In intervention group, procedure time was （33.06 ± 11.09） min, medical fees was （2 177.23 ± 221.65） yuan, there were two cases of adverse reactions, 1 case of recurrence after one year. In laparoscopy group, operation time was （57.41 ± 20.05） min, medical fees was （4 308.09 ± 322.62）yuan, 16 cases of adverse reactions, and 1 case of relapse after one year. In intervention group, there were eight cases of pregnancy and all left hospital with normal delivery while in laparoscopy group, there were 9 cases of pregnancy with seven cases of termination of pregnancy and 2 cases of normal childbirth. The procedure time, medical costs and adverse reaction rate between two groups had statistical difference, which was in favor of intervention group（P 〈 0.001）, but no difference was found in recurrence rate （P 〉 0.05）. [Conclusions]Both methods are effective on the treatment of ovarian cyst torsion. With broader surgical indications, laparoscopic surgery has been widely used in medical practice, but simpler procures, smaller patient trauma and less cost make ultrasound interventional puncture sclerotherapy more applicable for the basic units.