妊娠合并卵巢肿瘤腹腔镜手术治疗与开腹手术的比较(1)
【摘要】 目的：探讨妊娠中期行腹腔镜手术治疗妊娠合并卵巢肿瘤的可行性。方法：回顾性分析本院2007年
3月-2013年10月收治的40例中期妊娠合并卵巢肿瘤的患者，其中18例行全麻下腹腔镜手术为腹腔镜组，22例行椎管内麻醉下开腹手术为开腹组，比较两组的治疗效果及术后对妊娠的影响。结果：腹腔镜组卵巢肿瘤剥除12例，因肿瘤扭转行患侧附件切除6例，无1例转开腹手术，手术成功率100%；开腹组肿瘤剥除15例，附件切除7例，成功率为100%，两组比较差异无统计学意义(P>0.05)。腹腔镜组的手术时间、术中出血量、术后排气时间、术后住院天数分别为(45.68±6.24)min、(25.64±4.78)mL、(18.66±8.42)h、(3.24±1.02)d均明显优于开腹组的(55.46±6.18)min、(36.00±8.53)mL、(45.78±4.86)h、(7.12±1.46)d，两组比较差异均有统计学意义(P<0.05)。两组均无手术并发症，术后无流产迹象，随访至分娩，腹腔镜组15例妊娠38～39+5周自然分娩，3例因产科因素行剖宫产；开腹组16例妊娠37+5～40+2周自然分娩，6例因产科因素行剖宫产，两组妊娠孕周比较差异无统计学意义(P>0.05)。新生儿Apgar评分腹腔镜组(9.8±0.2)分，开腹组(9.7±0.3)分，两组比较差异无统计学意义(P>0.05)。结论：妊娠中期合并卵巢肿瘤有手术指征者应手术治疗，腹腔镜手术是安全可行的。
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【关键词】 卵巢肿瘤； 中期妊娠； 手术； 腹腔镜
Comparison between Laparoscopic and Open Surgery for Ovarian Tumor during Pregnancy/SUN Na.//Medical Innovation of China，2015，12(34)：074-077
【Abstract】 Objective：To investigate the feasibility of laparoscopic surgery for ovarian tumor during the second trimester of pregnancy.Method： 40 cases of mid-term pregnancy with ovarian tumors were admitted to our hospital from March 2007 to October 2013.18 cases were treated with laparoscopic surgery under general anesthesia as the laparoscopic group，22 cases were treated with traditional open surgery under intraspinal anesthesia as the open group，the therapeutic effects and the influence of pregnancy after surgery of two groups were compared.Result：In the laparoscopic group，12 cases of tumorectomy and 6 cases of adnexectomy were successfully performed ， the success rate was 100%；in the open group， 15 cases of tumor removal， 7 cases of appendix resection， the success rate is 100%，15 cases of tumorectomy and 7 cases of adnexectomy，the successful rate was 100%，the two groups had not statistically significance difference(P>0.05).The operation time， amount of bleeding， postoperative exhaust time and postoperative hospital stay of laparoscopic group was respectively (45.68±6.24)min， (25.64±4.78)mL，(18.66±8.42)h and (3.24±1.02)d，the open group of that was respectively (55.46±6.18)min，(36.00±8.53)mL，(45.78±4.86)h and (7.12±1.46)d， the laparoscopic group of these were better than the open group， the differences were statistically significant(P<0.05).Two groups had no surgery complications， no signs of abortion after surgery.Followed up to birth， 15 cases in the laparoscopic group with 38-39+5 weeks of natural delivery， 3 cases were due to obstetric factors of cesarean section；16 cases in the open group 37+5-40+2 weeks of natural childbirth pregnancy， 6 cases were due to obstetric factors of cesarean section，compared the gestational week of two groups， the difference was not statistically significant(P<0.05).The neonatal Apgar score of laparoscopic group was (9.8±0.2)score，laparotomy group was (9.7±0.3) score， compared two groups， the difference was not statistically significant(P<0.05).Conclusion：Ovarian tumor during the second trimester of pregnancy should be treated by surgery when it has surgery indications，laparoscopic surgery is safe and feasible., 百拇医药(孙娜)
3月-2013年10月收治的40例中期妊娠合并卵巢肿瘤的患者，其中18例行全麻下腹腔镜手术为腹腔镜组，22例行椎管内麻醉下开腹手术为开腹组，比较两组的治疗效果及术后对妊娠的影响。结果：腹腔镜组卵巢肿瘤剥除12例，因肿瘤扭转行患侧附件切除6例，无1例转开腹手术，手术成功率100%；开腹组肿瘤剥除15例，附件切除7例，成功率为100%，两组比较差异无统计学意义(P>0.05)。腹腔镜组的手术时间、术中出血量、术后排气时间、术后住院天数分别为(45.68±6.24)min、(25.64±4.78)mL、(18.66±8.42)h、(3.24±1.02)d均明显优于开腹组的(55.46±6.18)min、(36.00±8.53)mL、(45.78±4.86)h、(7.12±1.46)d，两组比较差异均有统计学意义(P<0.05)。两组均无手术并发症，术后无流产迹象，随访至分娩，腹腔镜组15例妊娠38～39+5周自然分娩，3例因产科因素行剖宫产；开腹组16例妊娠37+5～40+2周自然分娩，6例因产科因素行剖宫产，两组妊娠孕周比较差异无统计学意义(P>0.05)。新生儿Apgar评分腹腔镜组(9.8±0.2)分，开腹组(9.7±0.3)分，两组比较差异无统计学意义(P>0.05)。结论：妊娠中期合并卵巢肿瘤有手术指征者应手术治疗，腹腔镜手术是安全可行的。
, http://www.100md.com
【关键词】 卵巢肿瘤； 中期妊娠； 手术； 腹腔镜
Comparison between Laparoscopic and Open Surgery for Ovarian Tumor during Pregnancy/SUN Na.//Medical Innovation of China，2015，12(34)：074-077
【Abstract】 Objective：To investigate the feasibility of laparoscopic surgery for ovarian tumor during the second trimester of pregnancy.Method： 40 cases of mid-term pregnancy with ovarian tumors were admitted to our hospital from March 2007 to October 2013.18 cases were treated with laparoscopic surgery under general anesthesia as the laparoscopic group，22 cases were treated with traditional open surgery under intraspinal anesthesia as the open group，the therapeutic effects and the influence of pregnancy after surgery of two groups were compared.Result：In the laparoscopic group，12 cases of tumorectomy and 6 cases of adnexectomy were successfully performed ， the success rate was 100%；in the open group， 15 cases of tumor removal， 7 cases of appendix resection， the success rate is 100%，15 cases of tumorectomy and 7 cases of adnexectomy，the successful rate was 100%，the two groups had not statistically significance difference(P>0.05).The operation time， amount of bleeding， postoperative exhaust time and postoperative hospital stay of laparoscopic group was respectively (45.68±6.24)min， (25.64±4.78)mL，(18.66±8.42)h and (3.24±1.02)d，the open group of that was respectively (55.46±6.18)min，(36.00±8.53)mL，(45.78±4.86)h and (7.12±1.46)d， the laparoscopic group of these were better than the open group， the differences were statistically significant(P<0.05).Two groups had no surgery complications， no signs of abortion after surgery.Followed up to birth， 15 cases in the laparoscopic group with 38-39+5 weeks of natural delivery， 3 cases were due to obstetric factors of cesarean section；16 cases in the open group 37+5-40+2 weeks of natural childbirth pregnancy， 6 cases were due to obstetric factors of cesarean section，compared the gestational week of two groups， the difference was not statistically significant(P<0.05).The neonatal Apgar score of laparoscopic group was (9.8±0.2)score，laparotomy group was (9.7±0.3) score， compared two groups， the difference was not statistically significant(P<0.05).Conclusion：Ovarian tumor during the second trimester of pregnancy should be treated by surgery when it has surgery indications，laparoscopic surgery is safe and feasible., 百拇医药(孙娜)