微创医学

目的探讨超声引导下穿刺术治疗盆腔囊肿的疗效及安全性。方法选取133例盆腔囊肿患者为研究对象,采用随机抽样法分为穿刺组(A组)73例和开腹手术组(B组)60例,A组行超声引导下穿刺术,B组行传统开腹手术。术后1~6个月随访,对比两组患者近、远期疗效,记录其手术指标差异情况。结果 (1)A组术程、出血量、创口直径、住院时间及术后VAS评分等指标分别为(42.5±12.3)min、(32.8±4.4)m L、(2.3±0.5)mm、(2.3±0.5)d和(3.4±0.7)分,明显优于B组(P<0.05);A组穿刺成功73例,B组手术成功59例,两组成功率比较,差异无统计学意义(P>0.05);(2)两组患者术后1个月内治疗总有效率比较,差异无统计学意义(P>0.05),其中A组术后6个月总有效率提升至91.8%(70/73),B组则降低至65.0%(53/60),两组比较,差异有统计学意义(P<0.05);(3)A组随访期内复发2例,复发率为2.7%(2/73),同B组的3.3%(2/60)比较,差异无统计学意义(P>0.05);B组感染4例(6.7%)、妊娠8例(13.3%),A组无一例感染,妊娠27例(37.0%),差异有统计学意义(P<0.05);两组不良症状发生率均较低,差异无统计学意义(P>0.05)。结论对盆腔囊肿患者行超声引导下穿刺术,近期疗效显著,安全可靠。

Objective To investigate the safety and effectiveness of ultrasound-guided percutaneous puncture in treatment for pelvic cyst. Methods 133 cases of pelvic cyst were randomly divided into the puncture group (group A,n =73)and open surgical group (group B,n = 60). Those in group A received ultrasound guided paracentesis,and those in group B were given traditional open operation. The shortterm and longterm curative effect were compared. Results (1)In group A,the operation time,blood loss, wound indices such as diameter,length of hospital stay and postoperative VAS score were (42. 5 - 12. 3) min,respectively,ml (32. 8 ±4. 4),(2. 3 - 0. 5)mm,d (2. 3 - 0. 5)and (3. 4 - 0. 7),respectively, significantly better than those of group B (P < 0. 05). 73 cases were successful in group A,59 cases were successful in group B (P > 0. 05). (2)One month after treatment,the total effective rate showed no significant difference (P > 0. 05). Six months after treatment,the total effective rate of group A was up to 91. 8% ,while that of group B was reduced to 65. 0% (P <0. 05);(3)Two cases in group A recurred during the followup period,the recurrence rate was 2. 7% ,comparable with the rate of 3. 3% in group B (P >0. 05). In group B 4 cases were infected(6. 7% ),8 cases were pregnant (13. 3% ). In group A,no case was infected,and 27 cases became pregnant (37. 0% )(P <0. 05). The incidence of adverse symptoms was comparable between groups (P >0. 05 ). Conclusion Ultrasound-guided percutaneous puncture in treatment for pelvic cyst is safe and feasible,offering significant short-term effect.