老年肥胖妇女卵巢良性肿瘤手术方法的对比研究.docVIP

老年肥胖妇女卵巢良性肿瘤手术方法的对比研究 　　【摘要】 目的：探讨老年肥胖妇女卵巢良性肿瘤腹腔镜与开腹手术的疗效。方法：选取本院2006年1月-2011年12月收治的患有卵巢良性肿瘤且有手术指征的老年肥胖患者107例，按手术方法不同将其分为开腹组37例和腹腔镜组70例，比较两组患者术中及术后相关指标，并对其进行随访。结果：腹腔镜组的手术时间、术后排气时间、下床活动时间及住院时间均明显短于开腹组，术中出血量明显少于开腹组，住院费用明显高于开腹组，使用镇痛药比例和术后病率均明显低于开腹组，差异均有统计学意义（P0.01）。而腹腔镜组的术后并发症发生率4.3%明显低于开腹组的21.6%，比较差异有统计学意义（P0.05）。结论：腹腔镜手术优于开腹手术，具有创伤小、加速患者康复的优势，选择好适应证能降低老年肥胖患者的手术风险，是老年肥胖妇女卵巢良性肿瘤手术首选的手术方案。 　　【关键词】 腹腔镜； 肥胖； 卵巢良性肿瘤； 开腹手术 　　【Abstract】 Objective：To investigate the curative effect of laparoscopic operation and laparotomy in the treatment of elderly obese women with benign ovarian tumor.Method：107 elderly obese women with ovarian benign tumor who according with surgical indications admitted to our hospital from January 2006 to December 2011 were selected，they were divided into the laparotomy group for 37 cases and the laparoscopic operation group for 70 cases according to the different of operation methods，the intraoperative and postoperative related indicators between the two groups were compared，and were followed up.Result：The operation time，postoperative exhaust time，out of bed activity time and length of stay in the laparoscopic operation group were significantly shorter than those in the laparotomy group，the intraoperative bleeding of laparoscopic operation group was significantly less than the laparotomy group，the hospitalization expenses of laparoscopic operation group was significantly higher than the laparotomy group，the use of analgesics ratio and postoperative morbidity in laparoscopic operation group were significantly lower than those in the laparotomy group，the differences were statistically significant（P0.01）.The postoperative complication rate of laparoscopic operation group was （4.3%） significantly lower than 21.6% of the laparotomy group，the difference was statistically significant（P0.05）.Conclusion：Laparoscopic operation is better than laparotomy，the choice of a good indication can reduce the risk of elderly patients with obesity surgery，has the adva