文章摘要
单孔与传统腹腔镜治疗卵巢囊肿的疗效对比
Comparison of the therapeutic efficacy of single-port and traditional laparoscopy in treating ovarian cysts
投稿时间:2025-05-15  
DOI:10.3969/j.issn.1000-0399.2026.03.005
中文关键词: 卵巢囊肿  单孔腹腔镜  传统腹腔镜  抗缪勒管激素
英文关键词: Ovarian cyst  Laparoendoscopic single-site surgery  Conventional laparoscopy  Anti-Müllerian hormone
基金项目:湖北省自然科学基金计划项目(编号:2025AFC112)
作者单位E-mail
吕玮 430022 湖北武汉 武汉市第一医院妇产科  
谈秀娟 430022 湖北武汉 武汉市第一医院妇产科  
吴春林 430022 湖北武汉 武汉市第一医院妇产科 jbjp2003@163.com 
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中文摘要:
      目的 比较单孔腹腔镜手术(LESS)与传统多孔腹腔镜手术(CLS)在治疗卵巢囊肿中的临床疗效与安全性。方法 回顾性分析2023年2月至2024年3月在武汉市第一医院接受手术治疗的卵巢囊肿患者共86例,按术式不同分为LESS组和CLS组,每组43例。比较两组两组患者的基线资料,包括年龄、身体质量指数(BMI)、囊肿直径、术前癌抗原125(CA125)水平及婚育情况。比较两组术中出血量、术后排气时间、住院时间、术后24小时和48小时疼痛评分及术后并发症发生率差异。此外,比较两组卵巢功能指标的变化,包括黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)水平,并按年龄(≤35岁与>35岁)进行亚组分析,重点比较抗缪勒管激素(AMH)的变化差异。结果 两组基线资料无统计学差异(P>0.05)。LESS组在术中出血量(P=0.035)、术后排气时间(P<0.001)、住院时间(P<0.001)及术后24小时和48小时疼痛评分(P<0.001)均优于CLS组。两组黄体生成素(LH)、卵泡刺激素(FSH)及雌二醇(E2)变化比较,差异无统计学意义(P均>0.05);但在≤35岁患者中,LESS组的抗缪勒管激素(AMH)下降幅度小于CLS组(P=0.028)。两组术后总并发症发生率差异无统计学意义(P=0.314)。结论 与传统腹腔镜手术相比,单孔腹腔镜在治疗卵巢囊肿中具有术中创伤小、术后恢复快、疼痛轻、对卵巢功能保护更佳等优势,且安全性良好,具有较高的临床应用价值。
英文摘要:
      Objective To compare the clinical efficacy and safety of laparoendoscopic single-site surgery and conventional laparoscopic surgery in the treatment of ovarian cysts. Methods The clinical data of 86 patients with ovarian cysts who underwent surgical treatment at Wuhan First Hospital from February 2023 to March 2024 were retrospectively analyzed. According to the surgical approach, they were divided into a LESS group and a CLS group, with 43 cases in each group. The baseline characteristics of the two groups were compared, including age, body mass index(BMI), cyst diameter, preoperative CA125 level, and marital/childbearing status. The differences between the two groups in intraoperative blood loss, postoperative time to first flatus, hospital stay duration, pain scores at 24 h and 48 h postoperatively, and the incidence of postoperative complications were compared. Furthermore, changes in ovarian function indicators were compared between the two groups, including levels of luteinizing hormone(LH), follicle-stimulating hormone(FSH), and estradiol(E2). Additionally, subgroup analysis was performed based on age(≤35 years vs. >35 years), with a focus on comparing the differences in changes in anti-Müllerian hormone(AMH). Results There was no statistical difference in baseline data between the two groups(P>0.05). The LESS group was superior to the CLS group in terms of intraoperative blood loss(P=0.035), postoperative exhaust time(P<0.001), hospital stay(P<0.001), and pain scores at 24 h and 48 h postoperatively(P<0.001). Analysis of ovarian function showed no significant differences in the changes of LH, FSH, and E2 beP tween the two groups(all >0.05); however, in patients aged ≤35 years, the decline in Anti-Müllerian Hormone(AMH) was significantly smaller in the LESS group than in the CLS group(P=0.028). There was no statistically significant difference in the total incidence of postoperative complications between the two groups(P=0.314). Conclusion Compared with conventional laparoscopic surgery, LESS has advantages in reducing intraoperative trauma, accelerating postoperative recovery, alleviating pain, and better protecting ovarian function in the treatment of ovarian cysts, with good safety and high clinical application value.
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