腹腔镜下女性附件扭转保留卵巢的安全性及临床决策研究

Study on the safety and clinical decision making of laparoscopic torsion preserving ovarian surgery in women

摘要:

目的 研究腹腔镜下女性附件扭转保留卵巢的安全性及临床决策问题。方法 选取于该院妇科住院并行腹腔镜下保留卵巢手术的附件扭转患者38例，观察患者的发病时间、卵巢囊肿扭转周数、术中保留卵巢的指标、术中平均出血量、手术时间和术后生殖激素水平等。结果 38例患者中顺向扭转17例（44.74%），逆向扭转21例（55.26%）。平均扭转（1.28±0.44）周，手术时间（73.46±25.33）min，所有患者均顺利完成手术。术后平均血红蛋白下降（14.71±10.51）g/L，6例术后口服阿司匹林缓释片1个月，其余32例未作特殊处理。所有患者术后均无明显不适和并发症。术后复查超声均提示患侧卵巢恢复正常大小。结论 腹腔镜下附件扭转保留卵巢术，在卵巢质地不糟脆、剥离面有活动性出血的情况下，可行保留卵巢术，能避免切除患侧卵巢，并保留卵巢功能，可作为常规手术开展。

Abstract:

Objective To study the safety and clinical decision making of laparoscopic torsion preserving ovarian surgery in women.Methods Laparoscopic ovarian surgery was performed on 38 patients with adnexal torsion. The time of onset was observed, the number of weeks of ovarian cyst torsion, the index of preserving ovarian during surgery, the average amount of bleeding during the operation, the operation time and postoperative reproductive hormone levels, etc.Results Of the 38 patients, 17 had anterograde torsion (44.74%) and reverse torsion in 21 cases (55.26%). The mean twist was (1.28 ± 0.44) weeks and the operation time was (73.46 ± 25.33) min. All the patients successfully completed the operation. The average postoperative hemoglobin decreased was (14.71 ± 10.51) g/L. 6 patients received oral aspirin sustained-release tablets for one month after operation, the remaining 32 patients were not treated specially. All the patients had no obvious discomfort and complications after operation. Ultrasound after reexamination showed that the affected ovary returned to normal size.Conclusion Laparoscopic attachment reversed the ovarian preservation method. The ovarian can be preserved according to the ovarian texture is not fragile, and there is active bleeding on the peeling surface, which can avoid the removal of the affected ovary. It Can be carried out as a routine operation.