腹腔镜下电器械对卵巢组织热损伤的临床观察(1)
【摘要】 目的：探讨腹腔镜下电器械对卵巢组织热损伤的临床影响，以供参考。方法：将150例卵巢肿瘤患者纳入本研究，根据随机原则分为单极电凝组50例、双极电凝组50例和超声刀组50例，均在腹腔镜下进行治疗。对比三组患者的手术情况。结果：三组患者的手术时间、下床活动时间、肛门排气时间、住院时间和术后镇痛药物使用率比较差异均无统计学意义(P>0.05)。从卵巢组织热损伤坏死带深度和宽度来看，超声刀组损伤最小，其次为双极电凝组，损伤最大的为单极电凝组，差异有统计学意义(P<0.05)。结论：不同电器械对卵巢组织所产生的热损伤不同，超声刀带来的热损伤最小，其次是双极电凝，单极电凝带来的热损伤最大，临床上治疗时需根据实际情况考虑，尽量选用热损伤范围小的PK刀。最好选用缝合止血，从而减少卵巢组织的损伤，保护患者术后卵巢排卵的生育功能。
【关键词】 腹腔镜； 电器械； 卵巢组织热损伤； 临床观察
【Abstract】 Objective：To study the electro-surgical unit’s clinical influence on the heat injury of ovarian tissue under laparoscope，for reference.Method：150 ovarian tumor patients were involved in the study，and grouped according to the random principle.They were divided into three groups：group of monopolar electrocoagulation (50 cases)，group of bipolar electrocoagulation (50 cases)，group of electrocoagulation ultrasonic scalpel (50 cases).The surgical procedures of three groups were compared.Result：Compared the length of surgery under Laparoscopy，length of activities，length of gas passing，length of hospital stays and the usage rate of painkiller of three groups，the differences were not statistically significant (P>0.05).Though the study of the depth and width of the zone of thermal necrosis’s heat injury of ovarian tissue，we concluded that electrocoagulation ultrasonic scalpel imposed the minimum damages，bipolar electrocoagulation the second，and monopolar electrocoagulation the maximum，the differences were statistically significant (P<0.05).Conclusion：The influence on the heat injury of ovarian tissue varies from one to another under different electro-surgical units-electrocoagulation ultrasonic scalpel imposes the minimum damages，bipolar electrocoagulation the second，and monopolar electrocoagulation the maximum，subject to the practical situation of clinical theropy.It would be better if the PK knife which imposes the least damages is used.Sutured hemostasis would be a better choice to reduce the damage of the injury of ovarian tissue and protect the patients’ fertility function of ova production after surgery.
, 百拇医药
【Key words】 Laparoscope； Electro-surgical unit； Heat injury of ovarian tissue； Clinical observation
First-author’s address：The Traditional Chinese Medicine Hospital of Maoming，Maoming 525000，China
doi：10.3969/j.issn.1674-4985.2015.17.019
卵巢肿瘤常见于中年女性，是发生在女性卵巢上的生殖器肿瘤之一。多因患者机体因素和遗传因素导致，临床上早期常无明显症状，随病情发展或可出现腹胀腹痛、憋气，患者自觉腹中有一包块等症状，临床上表现为下腹部坠胀、不适感，腹围的增粗，腹内肿块感，月经紊乱，腹痛等，较大的囊肿可引起呼吸困难，心悸，下肢水肿等。卵巢囊肿多为良性，治疗以手术治疗为主。传统的开腹手术创伤大，术后恢复慢，剧烈的疼痛使患者难以耐受，往往需要采用镇痛药物治疗。近年来随着微创手术在妇科临床的广泛应用，腹腔镜下切除卵巢肿瘤的技术也日趋成熟[1-2]。但是腹腔镜下不同电器械对卵巢组织热损伤的影响不同，本文探讨了腹腔镜下电器械对卵巢组织热损伤的影响，现将结果报道如下，以供临床参考。, 百拇医药(黄春玲等)
【关键词】 腹腔镜； 电器械； 卵巢组织热损伤； 临床观察
【Abstract】 Objective：To study the electro-surgical unit’s clinical influence on the heat injury of ovarian tissue under laparoscope，for reference.Method：150 ovarian tumor patients were involved in the study，and grouped according to the random principle.They were divided into three groups：group of monopolar electrocoagulation (50 cases)，group of bipolar electrocoagulation (50 cases)，group of electrocoagulation ultrasonic scalpel (50 cases).The surgical procedures of three groups were compared.Result：Compared the length of surgery under Laparoscopy，length of activities，length of gas passing，length of hospital stays and the usage rate of painkiller of three groups，the differences were not statistically significant (P>0.05).Though the study of the depth and width of the zone of thermal necrosis’s heat injury of ovarian tissue，we concluded that electrocoagulation ultrasonic scalpel imposed the minimum damages，bipolar electrocoagulation the second，and monopolar electrocoagulation the maximum，the differences were statistically significant (P<0.05).Conclusion：The influence on the heat injury of ovarian tissue varies from one to another under different electro-surgical units-electrocoagulation ultrasonic scalpel imposes the minimum damages，bipolar electrocoagulation the second，and monopolar electrocoagulation the maximum，subject to the practical situation of clinical theropy.It would be better if the PK knife which imposes the least damages is used.Sutured hemostasis would be a better choice to reduce the damage of the injury of ovarian tissue and protect the patients’ fertility function of ova production after surgery.
, 百拇医药
【Key words】 Laparoscope； Electro-surgical unit； Heat injury of ovarian tissue； Clinical observation
First-author’s address：The Traditional Chinese Medicine Hospital of Maoming，Maoming 525000，China
doi：10.3969/j.issn.1674-4985.2015.17.019
卵巢肿瘤常见于中年女性，是发生在女性卵巢上的生殖器肿瘤之一。多因患者机体因素和遗传因素导致，临床上早期常无明显症状，随病情发展或可出现腹胀腹痛、憋气，患者自觉腹中有一包块等症状，临床上表现为下腹部坠胀、不适感，腹围的增粗，腹内肿块感，月经紊乱，腹痛等，较大的囊肿可引起呼吸困难，心悸，下肢水肿等。卵巢囊肿多为良性，治疗以手术治疗为主。传统的开腹手术创伤大，术后恢复慢，剧烈的疼痛使患者难以耐受，往往需要采用镇痛药物治疗。近年来随着微创手术在妇科临床的广泛应用，腹腔镜下切除卵巢肿瘤的技术也日趋成熟[1-2]。但是腹腔镜下不同电器械对卵巢组织热损伤的影响不同，本文探讨了腹腔镜下电器械对卵巢组织热损伤的影响，现将结果报道如下，以供临床参考。, 百拇医药(黄春玲等)