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目的比较经腹保守性和腹腔镜下手术治疗卵巢肿瘤蒂扭转的临床疗效。方法选取2014年2月-2015年2月该院收治的48例卵巢肿瘤蒂扭转患者,根据手术方式的不同分为经腹组和腹腔镜组,每组24例,比较2组患者手术疗效,并随访患者的卵巢功能。结果腹腔镜组患者手术时间、肛门排气时间、术中出血量及住院时间均低于经腹组,2组间差异有统计学意义(t=10.467 1,P<0.01;t=5.360 3,P<0.01;t=18.376 9,P<0.01;t=2.660 3,P<0.01);经腹组患者中有4例术后出现体温升高,通过抗生素治疗3 d后体温恢复正常,腹腔镜组患者中有3例术后出现体温升高,通过抗生素治疗2 d后体温恢复正常,2组间差异无统计学意义(χ~2=0.165 3,P>0.05),2组患者都没有发生下肢静脉栓塞或其他血栓并发症;术后随访2组患者3个月,腹腔镜组患者卵巢血供、卵巢大小及卵泡发育情况均优于经腹组,2组间差异有统计学意义(χ~2=4.363 6,P<0.05;χ~2=5.581 4,P<0.05;χ~2=5.400,P<0.05)。结论腹腔镜下手术治疗卵巢肿瘤蒂扭转疗效显著,术后并发症较少,显著提高了患者的生活质量,值得在临床上推广应用。
Objective To compare the clinical efficacy of transabdominal conservative surgery and laparoscopic surgery for the treatment of torsion in ovarian tumors. Methods Forty-eight patients with torsion of ovarian tumors who were admitted to our hospital from February 2014 to February 2015 were divided into transabdominal group and laparoscopic group according to different surgical methods, 24 cases in each group. The curative effect, And follow-up of patients with ovarian function. Results The laparoscopic operation time, anus exhaust time, intraoperative blood loss and hospital stay were lower than those of the transabdominal group, the difference was statistically significant (t = 10.467 1, P <0.01; t = 5.360 3, P <0.01; t = 18.3769, P <0.01; t = 2.6603, P <0.01); 4 patients in the transabdominal group had increased body temperature after operation. The body temperature returned to normal after 3 days of antibiotic treatment. Laparoscopy Three patients in group had elevated body temperature after operation, and body temperature returned to normal after 2 days of antibiotic treatment. There was no significant difference between the two groups (χ ~ 2 = 0.165 3, P> 0.05), and no difference was found between the two groups Lower extremity venous thromboembolism or other thromboembolic complications. After 3 months of follow-up in 2 groups, the ovarian blood supply, ovary size and follicular development in laparoscopic group were better than those in transabdominal group, the difference was statistically significant (χ ~ 2 = 4.363 6, P <0.05; χ ~ 2 = 5.581 4, P <0.05; χ ~ 2 = 5.400, P <0.05). Conclusions Laparoscopic surgery for the treatment of ovarian tumors Tiaoxie significant effect, less postoperative complications, significantly improving the quality of life of patients, it is worth in the clinical application.