妊娠合并卵巢良性肿瘤的腹腔镜治疗预后分析

目的 :探讨妊娠合并卵巢良性肿瘤患者腹腔镜下卵巢肿瘤剔除手术的临床价值。方法 :腹腔镜下对妊娠合并卵巢良性肿瘤患者行卵巢瘤剔出术 14例与开腹对妊娠合并卵巢瘤患者行卵巢瘤剔出术 2 4例进行对比分析。结果 :手术时间腹腔镜组5 1.79± 8.4 9min,开腹组 5 8.2 1± 6 .96 min,两组比较有显著差异 ,P<0 .0 5 ;出血量比较两组无显著差异 ;硫酸镁用量腹腔镜组2 1.4 3± 3.6 3g,明显低于开腹组 (37.14± 7.2 6 g) ,P<0 .0 1;术后排气时间腹腔镜组 2 4 .6 4± 4 .74 h,较开腹组 (4 3.14± 4 .87h)明显缩短 ,P<0 .0 1;术后住院天数腹腔镜组 4 .2 3± 0 .6 5 d,较开腹组 (7.4 3± 0 .5 1d)明显缩短。两组病例均无发生流产、早产、胎儿宫内窘迫等情况。结论 :妊娠合并卵巢良性肿瘤行腹腔镜手术是安全的 ,它可缩短手术时间、术后胃肠功能恢复快、住院时间缩短。提高手术操作技巧可减少和防止手术并发症的发生。手术时机适宜选择在妊娠 13～ 16周。

Prognosis analyses of laparoscopic treatment of ovarine benign tumors in pregnancy

Objective:To evaluate the clinical value of laparoscopic treatment of benign ovarine tumor in pregnancy.Methods:In 38 cases of the benign ovarine tumor patients during pregnancy underwent laparoscopy (14 cases)or laparotomy operation (24 cases) , the two treatment approach were compared.Results:In the laparoscopy group and the laparotomy group, the operation time was 51.79±8.49 minutes and 58.21±6.96 minutes respectively, laparoscopy group spent more time (P<0.05);the dosage of Mgso4 used after the operation was 21.43±3.63 g and 37.14±7.26 g respectively, laparoscopy group used the fewer dosage (P<0.01);the regained anal aerofluxus time after operation was 24.64±4.74 hours and 43.14±4.87 hours respectively, laparoscopy group was earlier (P<0.01);the days in hospital after operation was 4.23±0.65 days and 7.43±0.51 days respectively,the laparotomy group stayed more time. The blood lose had no variability in two groups (P>0.05). No abortions or preterm deliveries or IUGR occurred either in the laparoscopy group or in the laparotomy group.Conclusion:Laparoscopic operation carried out to treat the benign ovarine tumors in pregnancy is a safe approach. Laparoscopic approach can reduce operating time and shorten length of stay in hospital, the time of anal aerofluxus after operation was earlier. With elevating the technique of laparoscopic operation, the complication can be decreased or prevented. The suitable period undertaken laparoscopic operation is the 13～16 th week of pregnancy.