摘要
目的 探究单孔腹腔镜下子宫肌瘤剥除术围术期血液管理的策略及临床应用价值.方法 回顾分析 2019 年 1 月—2022 年 1 月因子宫肌瘤在郑州大学第三附属医院妇科病区行单孔腹腔镜下子宫肌瘤剥除术的 158 例患者的临床数据,根据是否进行血液管理分为实验组(79 例)和对照组(79 例).比较两组患者的手术相关指标、不良反应及术后并发症的发生情况.结果 实验组术后血红蛋白含量高于对照组(P<0.05);术中出血量、血红蛋白下降值、围术期输血率、手术时间、肛门排气时间、术后住院时长、术后炎症指标(白细胞、中性粒细胞百分比、C反应蛋白)、凝血指标(纤维蛋白原、D-二聚体)均小于对照组(P<0.05);不良反应及术后并发症总发生率少于对照组,但差异无统计学意义(P>0.05).结论 行单孔腹腔镜下子宫肌瘤剥除术的患者实施围术期血液管理至关重要.它可以减少术中出血、降低输血风险、提高手术疗效、促进患者康复,值得大力推广.
Abstract
Objective To explore the strategy and clinical application value of perioperative blood management in single-port laparoscopic myomectomy.Methods The clinical data of 158 patients who were operated with single-port laparoscopic myomectomy in the Gynecological Department of the Third Affiliated Hospital of Zhengzhou University due to uterine fibroids from January 2019 to January 2022 were reviewed and analyzed.According to whether blood management was performed or not,they were classified into experimental group(79 cases)and control group(79 cases).The surgical indexes,adverse reactions and postoperative complications were compared between the two groups.Results The experimental group's postoperative hemoglobin level was higher than that of the control group(P<0.05).The intraoperative bleeding,drop values of postoperative hemoglobin,rate of perioperative blood transfusion,operation time,anal defecation time,postoperative hospital stay,and postoperative inflammation indexes(leukocytes,percentage of neutrophils,and C-reactive protein),coagulation index(fibrinogen,D-dimer)were less than those of the control group(P<0.05).The total incidence of adverse reactions and postoperative complications was lower than that of the control group,but the difference was not statistically significant(P>0.05).Conclusion Perioperative blood management is crucial for patients undergoing single-port laparoscopic myomectomy.It can reduce intraoperative bleeding,decrease the risk of blood transfusion,improve surgical efficacy,promote patient recovery,and is worth promoting.
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