腹腔镜手术治疗妊娠合并卵巢囊肿的可行性和安全性及其对妊娠结局的影响评价

莫金凤

[摘要]目的 研究并探討腹腔镜手术治疗妊娠合并卵巢囊肿的可行性和安全性及其对妊娠结局的影响。方法 选取2010年1月～2016年5月我院收治的80例妊娠合并卵巢囊肿患者作为研究对象，采取计算机单盲随机分组方法将患者随机分为两组，每组各40例。对照组采取开腹卵巢囊肿剥除术治疗，观察组采取腹腔镜卵巢囊肿剥除术治疗，比较两组手术情况、妊娠结局。结果 手术情况：观察组的手术用时明显短于对照组（P<0.05），其术中出血量明显少于对照组（P<0.05）；观察组的术后下床活动时间、首次排气时间均明显早于对照组（P<0.05），其术后住院天数明显短于对照组（P<0.05），且观察组的术后疼痛评分明显低于对照组（P<0.05）；术后并发症方面，观察组的并发症发生率显著低于对照组（P<0.05）；性激素方面，观察组术后的促黄体生成素、促卵泡生成素、雌二醇明显增高，且其均高于对照组术后（P<0.05）。妊娠结局：观察组的剖宫产率明显低于对照组（P<0.05），而观察组与对照组在早产率、流产率、新生儿窒息率方面比较，差异均无统计学意义（P>0.05）。结论 针对妊娠合并卵巢囊肿患者采取腹腔镜卵巢囊肿剥除术治疗切实可行，不仅具有手术创伤少、术后恢复快、并发症少等优势，还可有效确保妊娠结局的安全性，避免不良妊娠结局。

[关键词]妊娠；卵巢囊肿；卵巢囊肿剥除术；腹腔镜

[中图分类号] R737.31 [文献标识码] A [文章编号] 1674-4721（2017）07（a）-0109-04

Evaluation of the feasibility and safety of laparoscopic surgery for ovarian cysts in pregnancy and its impact on pregnancy outcome

MO Jin-feng

Department of Gynaecology，the First People′s Hospital of Foshan，Guangdong Province，Foshan 528000，China

[Abstract]Objective To study and discuss the feasibility and safety of laparoscopic surgery in the treatment of pregnancy complicated with ovarian cyst and its influence on the pregnancy outcome.Methods From January 2010 to May 2016，80 cases of pregnancy patients with ovarian cyst were selected as the research object，the patients were randomly divided into two groups by taking computer single blind randomization method，the control group was given the conventional ovarian cystectomy treatment，the observation group was given laparoscopic ovarian cyst resection treatment.The operation condition and outcome were compared between two groups.Results Operation situation：the operation time in the observation group was significantly shorter than the control group （P<0.05），the amount of bleeding during operation was significantly less than the control group （P<0.05）；postoperative ambulation time and exhaust time for the first time in the observation group were significantly earlier than the control group （P<0.05）；the postoperative hospital stay in the observation group was significantly shorter than the control group （P<0.05）；pain score in the observation group after surgery was significantly lower than the control group （P<0.05）；the rate of postoperative complications in the observation group was significantly lower than the control group （P<0.05）；sex hormone，luteinizing hormone，follicle stimulating hormone and estradiol glycol in the observation group after surgery were significantly increased and higher than the control group after surgery （P<0.05）.Pregnancy outcomes：the cesarean section rate in the observation group was significantly lower than that of the control group （P<0.05），while the rate of premature delivery，the rate of miscarriage and the rate of neonatal asphyxia were compared between the observation group and the control group，there were no significant differences （P>0.05）.Conclusion For patients with ovarian cyst of pregnancy by laparoscopic ovarian cyst resection treatment is feasible，not only has less surgical trauma，faster postoperative recovery，less complications and other advantages，can effectively ensure the safety of pregnancy outcomes，avoid adverse pregnancy outcomes.

[Key words]Pregnancy；Ovarian cyst；Enucleation of ovarian cyst；Laparoscopy

卵巢囊腫是一种常见的女性生殖系统肿瘤，临床表现以盆腔包块为主，主要为良性肿瘤，有少数恶性肿瘤[1-2]。妊娠合并卵巢囊肿主要是指卵巢囊肿患者妊娠或妊娠期罹患卵巢囊肿，无论是哪种，一旦合并卵巢囊肿，患者的妊娠和分娩均会受到一定程度的影响，需谨慎处理，尽可能保证母婴的生命安全[3]。近年来，随着腹腔镜技术的日臻成熟，腹腔镜技术在卵巢囊肿剥除术中的应用越来越常见，本次研究旨在探讨腹腔镜手术治疗妊娠合并卵巢囊肿的可行性和安全性及其对妊娠结局的影响，为此，针对我院收治的80例妊娠合并卵巢囊肿患者进行研究，将采取腹腔镜卵巢囊肿剥除术、开腹卵巢囊肿剥除术的妊娠合并卵巢囊肿患者进行比较，并作如下报道。……