腹腔镜手术和开腹手术治疗老年卵巢囊肿疗效观察

目的 探讨腹腔镜手术与开腹手术治疗卵巢囊肿的临床疗效.方法 对2004年6月～2011年10月期间在某院行良性卵巢囊肿手术治疗的78例老年患者临床资料进行了回顾性分析,分析两组患者术中出血量、手术时间、术后排气时间、术后3d之内平均体温、住院时间、住院费用、患者手术方式及手术标本病理检查结果.结果 分析两组患者手术时间、术中出血量、术后排气时间、住院费用、住院时间等指标,两组之间比较差异有统计学意义(P＜0.05)；手术方式比较,开腹组行囊肿剥除术者2例,附件切除术19例,腹腔镜组行囊肿剥除术者11例,附件切除术者46例,两组在手术方式上比较差异无统计学意义(P＞0.05)；病理检查囊肿性质主要为炎症性囊肿、成熟畸胎瘤、浆液性囊腺瘤、粘液性囊腺瘤等为主,腹腔镜组及开腹组患者均以炎症性囊肿所占构成比最高,腹腔镜组为38.60％,开腹组为57.14％,其次为成熟畸胎瘤,腹腔镜组为17.54％,开腹组为14.29％.结论 腹腔镜手术治疗老年卵巢囊肿较开腹手术治疗有术后恢复快、并发症少等优点,但并不能完全取代开腹手术,选择何种术式要根据患者的病情特点决定.

Observation on curative effect of laparoscopic operation and open operation in treatment of elderly ovarian cyst

OBJECTIVE To investigate the clinical efficacy of laparoscopic surgery and laparotomy in treating ovarian cysts.METHODS From June 2004 to October 2011,our hospital with 78 elderly patients of benign ovarian cyst surgery’ clinical data were retrospectively analyzed.Analyzed intraoperative blood loss,operation time,exhaust time,average body temperature within three days after operation,duration of hospitalization,hospital fees,surgical approach and surgical specimens of pathological findings in two groups.RESULTS The operative time,blood loss,postoperative passage of flatus,hospital costs,length of stay indicators between the two groups were significantly different(P﹤0.05);compared surgical approaches,laparotomy group underwent cystectomy two cases,19 cases oophorectomy,laparoscopic group underwent cystectomy 11 cases,oophorectomy in 46 cases,there was no significant difference(P﹥0.05);pathological examination showed the cysts were mainly inflammatory cysts,mature teratoma,serous cystadenoma,mucinous cystadenoma,constitute ratio of inflammatory cysts in laparoscopy group were higher than in laparotomy group patients,former 38.60% and latter 57.14%,followed by a mature teratoma,17.54% in the laparoscopic group,14.29% in the laparotomy group.CONCLUSION Compared with laparotomy,laparoscopic surgical treatment for elderly ovarian cysts has a quicker postoperative recovery,fewer complications,but it does not completely replace open surgery,the choice of surgical procedures is determined according to the conditions of the patients.