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目的探讨腹腔镜手术在妊娠合并卵巢囊肿诊治中的可行性和安全性。方法2003-08-2006-02佛山市第一人民医院对21例妊娠合并卵巢囊肿患者(腹腔镜组)施行腹腔镜诊断和手术治疗,并与同期接受剖腹手术的12例患者(剖腹组)的手术资料和妊娠结局进行对比分析。结果腹腔镜组卵巢囊肿剥除术和患侧附件切除术分别为18例和3例,剖腹组分别为10例和2例。腹腔镜组平均手术时间、术中出血量、术后导尿管停留时间和术后住院时间分别为66.1min、29.8mL、9.2h和6.0d。术后24h均下床活动,不需使用镇痛药物。剖腹组上述指标分别为99.6min、72.5mL、38.7h和9.2d。术后48h后方能下床活动。腹腔镜组各项指标均优于剖腹组(P<0.05)。两组术后先兆流产和完全流产发生率分别为4.8%和33.3%,差异无统计学意义(P>0.05)。结论早、中期妊娠时应用腹腔镜手术治疗卵巢囊肿是安全可行的。
Objective To investigate the feasibility and safety of laparoscopic surgery in the diagnosis and treatment of ovarian cyst with pregnancy. Methods The First People ’s Hospital of Foshan City performed laparoscopic diagnosis and surgical treatment on 21 cases of pregnancy complicated with ovarian cyst (laparoscopic group) and 12 cases (laparotomy group) undergoing laparotomy concurrently Surgical data and pregnancy outcomes were compared. Results In the laparoscopic group, ovarian cyst excision and ipsilateral adjuvant resection were performed in 18 cases and 3 cases, respectively, and in the laparotomy group, 10 cases and 2 cases, respectively. The mean operation time, intraoperative blood loss, postoperative catheter stay and postoperative hospital stay were 66.1min, 29.8mL, 9.2h and 6.0d, respectively. After 24h activities are out of bed, do not need to use analgesics. Caesarean section of the above indicators were 99.6min, 72.5mL, 38.7h and 9.2d. After 48h before getting out of bed activity. The indexes of laparoscopic group were better than those of laparotomy group (P <0.05). The incidence of threatened abortion and complete abortion in the two groups were 4.8% and 33.3% respectively, with no significant difference (P> 0.05). Conclusion It is safe and feasible to apply laparoscopic surgery for ovarian cysts in early pregnancy and mid-term pregnancy.