| 摘要: |
| ［摘要］ 目的 观察脐+1孔腹腔镜VICRYL棒球缝合法治疗直径≥10 cm巨大子宫肌瘤的效果。方法 回顾性分析2021年9月至2023年6月廊坊市人民医院收治的巨大子宫肌瘤患者的临床资料，其中接受脐+1孔腹腔镜VICRYL棒球缝合法治疗的52例作为观察组，采用1∶1配对法选入接受常规四孔腹腔镜手术者52例作为对照组。比较两组围手术期指标、术后视觉模拟量表（VAS）评分、创伤应激指标［超氧化物歧化酶（SOD）、活性氧（ROS）、C反应蛋白（CRP）、谷胱甘肽过氧化物酶（GSH-Px）］、切口满意度和并发症发生情况。结果 观察组手术时间短于对照组，肛门排气时间和首次下床活动时间早于对照组，差异有统计学意义（P<0.05）。两组术中出血量、住院时间比较差异无统计学意义（P>0.05）。观察组术后6 h、9 h、12 h、24 h、32 h的VAS评分均显著低于对照组（P<0.05）。在术后第1天和术后第3天，观察组CRP和ROS水平低于对照组，GSH-Px和SOD水平高于对照组，差异有统计学意义（P<0.05）。观察组切口主观满意率显著高于对照组（98.08% vs 75.00%； χ2=11.886，P=0.001）。两组并发症发生率比较差异无统计学意义（3.85% vs 1.92%； χ2=0.000，P=1.000）。结论 脐+1孔腹腔镜VICRYL棒球缝合法治疗直径≥10 cm巨大子宫肌瘤安全可行，切口美观度好，利于患者术后早期康复。 |
| 关键词: 巨大子宫肌瘤 腹腔镜 VICRYL棒球缝合法 切口 疼痛 |
| DOI：10.3969/j.issn.1674-3806.2025.09.15 |
| 分类号:R 713.4 |
| 基金项目:河北省医学科学研究课题计划资助（编号：20251468） |
|
| Observation on clinical efficacy of transumbilical single-incision plus one-port laparoscopy with VICRYL baseball suture technique in treating giant uterine fibroids with a diameter ≥10 cm |
|
ZHAO Yanhong, GAO Jianhong, XU Donglei, SUN Peipei, ZHANG Jing
|
|
Department of Gynecology, the People′s Hospital of Langfang City, Langfang 065800, China
|
| Abstract: |
| ［Abstract］ Objective To observe the clinical efficacy of transumbilical single-incision plus one-port laparoscopy with VICRYL baseball suture technique in treating giant uterine fibroids with a diameter ≥10 cm. Methods A retrospective analysis was conducted on the clinical data of the patients with giant uterine fibroids who were admitted to the People′s Hospital of Langfang City from September 2021 to June 2023. In the patients, 52 patients who received the treatment of transumbilical single-incision plus one-port laparoscopy with VICRYL baseball suture technique were selected as observation group, while other 52 patients who received conventional four-port laparoscopic surgery by using a matching method at a ratio of 1∶1 were selected as control group. The perioperative indicators, postoperative Visual Analogue Scale(VAS) scores, trauma stress indicators［superoxide dismutase(SOD), reactive oxygen species(ROS), C-reactive protein(CRP), glutathione peroxidase(GSH-Px)］, patient subjective satisfaction with surgical incision and the occurrence of complications were compared between the two groups. Results The duration of operation in the observation group was shorter than that in the control group, and time to first anal exhaust and time to first ambulation after operation in the observation group was earlier than that in the control group, with statistically significant differences(P<0.05). There were no statistically significant differences in intraoperative blood loss and hospital stay between the two groups(P>0.05). The VAS scores at 6 hours, 9 hours, 12 hours, 24 hours and 32 hours after operation in the observation group were significantly lower than those in the control group(P<0.05). On the first and third days after operation, the levels of CRP and ROS in the observation group were lower than those in the control group, while the levels of GSH-Px and SOD in the observation group were higher than those in the control group, with statistically significant differences(P<0.05). The rate of patient subjective satisfaction with surgical incision in the observation group was significantly higher than that in the control group(98.08% vs 75.00%; χ2=11.886, P=0.001). There was no statistically significant difference in the incidence of complications between the two groups(3.85% vs 1.92%; χ2=0.000, P=1.000). Conclusion The transumbilical single-incision plus one-port laparoscopy with VICRYL baseball suture technique is a safe and feasible treatment for giant uterine fibroids with a diameter ≥10 cm, with good patient subjective satisfaction with surgical incision, and benefits for early postoperative recovery of the patients. |
| Key words: Giant uterine fibroid Laparoscope VICRYL baseball suture Surgical incision Pain |
