腹腔镜下电器械对卵巢组织热损伤的临床观察

摘要

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.%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。