全子宫切除术后卵巢肿物特点及腹腔镜下手术技巧研究

发布时间：2018-02-08 12:57

本文关键词： 卵巢肿物全子宫切除术腹腔镜手术　出处：《中国实用妇科与产科杂志》2017年03期 　论文类型：期刊论文

【摘要】：目的探讨因良性疾病或癌前病变行全子宫切除术后卵巢肿物的特点,并总结腹腔镜下手术治疗的技巧。方法收集2005年8月至2013年8月于河北医科大学第四医院因全子宫切除术后盆腔肿物接受手术治疗的132例患者临床资料,对卵巢肿物的良恶性、患者发病年龄以及再次手术与初次手术时间间隔进行分析。结果 132例患者中,卵巢良性肿物94例,占71.21%,其中以卵巢单纯囊肿、卵巢巧克力囊肿多见;恶性肿瘤38例,占28.79%,以卵巢浆液性囊腺癌多见。全子宫切除术后卵巢肿瘤好发年龄为45~55岁。全子宫切除术后卵巢良性肿物及恶性肿瘤多发生在术后10年内。腹腔镜下手术时,宜注意穿刺孔的选择、粘连的分解以及输尿管位置的改变。结论全子宫切除术后卵巢肿物以良性居多,可以选择腹腔镜探查。手术时套管穿刺位置选择宜远离原切口瘢痕,分离粘连时注意输尿管位置的改变,可以有效地降低腹腔镜转开腹手术率及手术损伤的机会。
[Abstract]:Objective to investigate the characteristics of ovarian masses after hysterectomy due to benign diseases or precancerous lesions. Methods from August 2005 to August 2013, the clinical data of 132 patients undergoing surgical treatment for pelvic masses after hysterectomy were collected from August 2005 to August 2013 in Hebei Medical University, 4th Hospital. Results among 132 patients, 94 cases were benign ovarian masses (71.21%), including ovarian simple cyst, ovarian chocolate cyst, malignant tumor 38 cases. The age of ovarian neoplasms after hysterectomy was 45 ~ 55 years. Benign ovarian masses and malignant tumors occurred in 10 years after total hysterectomy. Attention should be paid to the choice of puncture orifice, the decomposition of adhesions and the change of ureteral location. Conclusion the ovarian masses after total hysterectomy are mostly benign, and laparoscopic exploration can be chosen. Paying attention to the change of ureter position when separating adhesions can effectively reduce the rate of laparoscopic conversion to laparotomy and the chance of surgical injury.
【作者单位】：河北医科大学第四医院妇产科;
【基金】：河北省医学科学研究重点课题计划指令性课题项目(ZD20140419)
【分类号】：R713.42

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