腹腔镜手术治疗脐尿管囊肿疗效及安全性研究
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摘要
目的:研究腹腔镜手术治疗脐尿管囊肿的安全性。方法:选择因尿频、脐周疼痛、血尿、发热等入院治疗并确诊为脐尿管囊肿的患者43例,按照患者手术方法不同分为传统组20例,腹腔镜组23例。传统组患者行传统开腹手术治疗,腹腔镜组患者行腹腔镜下手术治疗。比较两组患者围术期相关资料,包括手术时间、出血量、住院时间、留置导尿时间;使用Spitzer生存质量评分表对两组患者术后1周的生活质量进行评分;使用本院自制的满意度评价表对两组患者的治疗满意度进行分析;比较两组患者治疗后的复发率和并发症发生率,包括:腹痛、泌尿系统感染、脐部或膀胱不适以及漏尿等。结果:腹腔镜组患者的手术时间、术中出血量、住院时间和留置导尿时间均显著低于传统组(P<0.05)。传统组与腹腔镜组在活动、日常生活、支持、精神及健康评分之间比较差异无统计学意义(P>0.05),腹腔镜组总分显著高于传统组(P<0.05)。传统组与腹腔镜组的满意度相比差异无统计学意义(P>0.05)。对患者进行为期1年的随访发现,传统组和腹腔镜组患者均未发生脐尿管囊肿的复发。两组患者术后并发症发生率经比较差异无统计学意义(P>0.05)。结论:与传统开腹手术相比,腹腔镜手术治疗脐尿管囊肿能够明显改善患者的围术期指标,提高生活质量,且治疗满意度高,术后复发率低,安全性好。
Objective To study the safety evaluation of laparoscopic treatment of urachal cyst. Methods:43 patients with urinary tract cysts for urinary frequency, umbilical pain, hematuria, and fever were selected.According to the different surgical methods, the patients were divided into the traditional group and the laparoscopic group, including 20 cases in the traditional group and 23 cases in the laparoscopic group.Patients in the traditional group underwent conventional open surgery, and patients in the laparoscopic group underwent laparoscopic surgery. The perioperative data of the two groups were compared, including the operation time, the amount of bleeding, the length of hospital stay, and the time of indwelling catheterization.The quality of life of the two groups of patients was scored 1 week after surgery using the spitzer quality of life scale. The treatment satisfaction of the two groups of patients were analyzed using our self-made satisfaction evaluation form. The postoperative recurrence rate and complication rate after treatment were compared between the two groups, including abdominal pain, urinary tract infection, umbilical or bladder discomfort, and leakage of urine.Results:Compared with the conventional group, the operation time, intraoperative blood loss, hospitalization time and indwelling catheterization time of the laparoscopic group were significantly lower than those of the laparoscopic group(P<0.05).There was no significant difference in activity, daily life, support, mental and health scores between the traditional group and the laparoscopic group(P>0.05). The total score of quality of life in the laparoscopic group was significantly higher than that in the traditional group(P<0.05).There was no significant difference between the traditional group and the laparoscopic group(P>0.05).A one-year follow-up of the patients revealed no recurrence of urachal cysts in the conventional and laparoscopic groups.There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion Compared with traditional open surgery, laparoscopic treatment of urachal cysts can significantly improve perioperative data, improve quality of life, and have high satisfaction with treatment, low postoperative recurrence rate, good safety.
Objective To study the safety evaluation of laparoscopic treatment of urachal cyst. Methods:43 patients with urinary tract cysts for urinary frequency, umbilical pain, hematuria, and fever were selected.According to the different surgical methods, the patients were divided into the traditional group and the laparoscopic group, including 20 cases in the traditional group and 23 cases in the laparoscopic group.Patients in the traditional group underwent conventional open surgery, and patients in the laparoscopic group underwent laparoscopic surgery. The perioperative data of the two groups were compared, including the operation time, the amount of bleeding, the length of hospital stay, and the time of indwelling catheterization.The quality of life of the two groups of patients was scored 1 week after surgery using the spitzer quality of life scale. The treatment satisfaction of the two groups of patients were analyzed using our self-made satisfaction evaluation form. The postoperative recurrence rate and complication rate after treatment were compared between the two groups, including abdominal pain, urinary tract infection, umbilical or bladder discomfort, and leakage of urine.Results:Compared with the conventional group, the operation time, intraoperative blood loss, hospitalization time and indwelling catheterization time of the laparoscopic group were significantly lower than those of the laparoscopic group(P<0.05).There was no significant difference in activity, daily life, support, mental and health scores between the traditional group and the laparoscopic group(P>0.05). The total score of quality of life in the laparoscopic group was significantly higher than that in the traditional group(P<0.05).There was no significant difference between the traditional group and the laparoscopic group(P>0.05).A one-year follow-up of the patients revealed no recurrence of urachal cysts in the conventional and laparoscopic groups.There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05). Conclusion Compared with traditional open surgery, laparoscopic treatment of urachal cysts can significantly improve perioperative data, improve quality of life, and have high satisfaction with treatment, low postoperative recurrence rate, good safety.
引文
[1] 刘涛,武玉睿,王春华,等.儿童脐尿管囊肿腹腔镜手术治疗的初步探讨[J].中华腔镜外科杂志:电子版,2017,10(5):315-318.
[2] Kidger E,Stahlschmidt J,Garthwaite M,et al.A rare urachal cyst in a case of ketamine-induced cystitis provides mechanistic insights[J].Urology,2016,90:2231-2237.
[3] 刘莉,穆靓,韦爱华,等.超声检查在脐尿管癌诊断中的应用价值[J].陕西医学杂志,2012,41(11):1490-1491.
[4] 刘铭,许超,姜先洲,等.13例脐尿管囊肿的诊断分析[J].医学与哲学,2014,35(4):42-44.
[5] 朱艳珊,许亮,赵敏,等.脐尿管囊肿合并感染的超声诊断价值分析[J].中华医院感染学杂志,2012,22(12):2578-2579.
[6] 黄岚,符柳江,方倩,等.小儿脐部病变的超声诊断[J].临床超声医学杂志,2017,19(9):644-645.
[7] 魏义,许丽娜,李博.腹腔镜脐尿管囊肿切除合并膀胱部分切除术治疗脐尿管囊肿(附2例报告)[J].泌尿外科杂志:电子版,2014(3):29-32.
[8] 刘娇,宫大鑫,孔垂泽.15例脐尿管病变的诊治分析[J].现代肿瘤医学,2017,25(7):1081-1083.
[9] 陈思雨.腹腔镜脐尿管癌手术切除的临床研究[D].山东大学,2017.
[10] 杨金辉,孙建涛,郝彤彤,等.腹腔镜下治疗成人脐尿管囊肿的临床分析[J].国际泌尿系统杂志,2017,37(1):88-90.
[11] 贺文彦,张芙蓉,张建勋.1例脐尿管囊肿合并感染报道并文献复习[J].齐齐哈尔医学院学报,2017,38(3):372-373.
[12] 廖土明,王宇雄,王鹏,等.脐尿管囊肿并急性期感染的临床诊治分析[J].青海医药杂志,2015,45(3):18-20.
[13] 王立勇,李瑞平,任浩棠,等.小儿脐尿管囊肿23例诊治分析[J].赣南医学院学报,2013,33(3):386-387.
[14] 李猛,赵积晔,田兵,等.成人脐尿管囊肿2例的诊疗体会[J].中国实用医药,2013,8(15):175-176.
[15] 龚根强,王建军.开腹手术与腹腔镜手术对治疗结肠癌260例效果评价[J].陕西医学杂志,2016,45(9):1177-1179.
[16] 沙建军,吴小荣,张连华,等.腹腔镜治疗成人脐尿管囊肿3例及文献复习[J].临床泌尿外科杂志,2011,26(10):764-766.
[2] Kidger E,Stahlschmidt J,Garthwaite M,et al.A rare urachal cyst in a case of ketamine-induced cystitis provides mechanistic insights[J].Urology,2016,90:2231-2237.
[3] 刘莉,穆靓,韦爱华,等.超声检查在脐尿管癌诊断中的应用价值[J].陕西医学杂志,2012,41(11):1490-1491.
[4] 刘铭,许超,姜先洲,等.13例脐尿管囊肿的诊断分析[J].医学与哲学,2014,35(4):42-44.
[5] 朱艳珊,许亮,赵敏,等.脐尿管囊肿合并感染的超声诊断价值分析[J].中华医院感染学杂志,2012,22(12):2578-2579.
[6] 黄岚,符柳江,方倩,等.小儿脐部病变的超声诊断[J].临床超声医学杂志,2017,19(9):644-645.
[7] 魏义,许丽娜,李博.腹腔镜脐尿管囊肿切除合并膀胱部分切除术治疗脐尿管囊肿(附2例报告)[J].泌尿外科杂志:电子版,2014(3):29-32.
[8] 刘娇,宫大鑫,孔垂泽.15例脐尿管病变的诊治分析[J].现代肿瘤医学,2017,25(7):1081-1083.
[9] 陈思雨.腹腔镜脐尿管癌手术切除的临床研究[D].山东大学,2017.
[10] 杨金辉,孙建涛,郝彤彤,等.腹腔镜下治疗成人脐尿管囊肿的临床分析[J].国际泌尿系统杂志,2017,37(1):88-90.
[11] 贺文彦,张芙蓉,张建勋.1例脐尿管囊肿合并感染报道并文献复习[J].齐齐哈尔医学院学报,2017,38(3):372-373.
[12] 廖土明,王宇雄,王鹏,等.脐尿管囊肿并急性期感染的临床诊治分析[J].青海医药杂志,2015,45(3):18-20.
[13] 王立勇,李瑞平,任浩棠,等.小儿脐尿管囊肿23例诊治分析[J].赣南医学院学报,2013,33(3):386-387.
[14] 李猛,赵积晔,田兵,等.成人脐尿管囊肿2例的诊疗体会[J].中国实用医药,2013,8(15):175-176.
[15] 龚根强,王建军.开腹手术与腹腔镜手术对治疗结肠癌260例效果评价[J].陕西医学杂志,2016,45(9):1177-1179.
[16] 沙建军,吴小荣,张连华,等.腹腔镜治疗成人脐尿管囊肿3例及文献复习[J].临床泌尿外科杂志,2011,26(10):764-766.