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| 1 | 不同术式在老年子宫肌瘤患者中应用效果及对卵巢状态的影响显示文摘目的观察不同术式在老年子宫肌瘤患者中应用效果及对卵巢状态的影响。方法80例老年子宫肌瘤患者根据术式分为A组(开腹手术组)和B组(腹腔镜手术组)各40例。比较两组手术前后炎性应激指标、卵巢血流、卵巢血流灌注参数及激素水平、出血量、胃肠功能恢复情况、并发症发生率。结果术前两组炎性应激指标、卵巢血流、卵巢血流灌注参数及激素水平差异无统计学意义(P>0.05),术后不同时间B组炎性应激指标、卵巢血流、卵巢血流灌注参数及激素水平均显著优于A组(P<0.05),B组出血量显著少于A组,胃肠功能恢复指标显著优于A组,并发症发生率显著低于A组(P<0.05)。结论腹腔镜手术在老年子宫肌瘤患者中应用效果较好,且对卵巢状态不良影响较小,炎性损伤控制较好。 | 孙启建 刘鹏 尹笋 | 2020 | 中国老年学杂志2020，40，19： | 3 |
| 2 | 全子宫切除术后盆腔肿块的发生因素调查分析显示文摘目的:调查与探讨全子宫切除术后患者出现盆腔肿块的发生因素。方法:2017年9月至2019年3月选择在北部战区总医院(本院)进行择期全子宫切除术的女性患者178例,所有患者都给予全子宫切除术,患者取膀胱截石位,选用连续硬膜外麻醉或静脉复合麻醉,宫颈扩张棒扩张宫颈口,切除病灶部位。记录所有患者的一般资料(包括疾病类型、孕次、产次、年龄、体重指数等)与围手术期指标(包括手术时间、术中出血量、术后排气时间、术后住院时间),以及术后并发症发生情况;在术后6个月进行经阴道超声观察,判断患者术后盆腔肿块发生情况并进行调查分析。结果:术后随访6个月,178例患者中发生盆腔肿块14例,发生率为7.9%。发生其他并发症17例,其中切口感染4例,淋巴囊肿6例,尿潴留5例,下肢静脉血栓2例。在178例患者中,不同手术时间、术中出血量、孕次、产次、年龄、疾病类型患者的盆部肿发生率对比差异有统计学意义(P<0.05)。以单因素分析中有统计学意义的指标作为自变量,以盆腔肿块作为因变量,Logistic回归分析显示手术时间、孕次、产次、疾病类型等为导致盆腔肿块发生的主要因素(P<0.05)。结论:女性全子宫切除术后患者盆腔肿块比较常见,手术时间、孕次、产次、疾病类型等为导致盆腔肿块发生的主要因素。 | 赵冬冰 侯广霞 赵丽 满竹 吴艳云 | 2021 | 现代生物医学进展2021，21，1： | 2 |
| 3 | Laparoscopic management of a giant mucinous benign ovarian mass weighing 10150 grams:A case report显示文摘BACKGROUND Giant ovarian cysts(≥15 cm in diameter)are rare.The size limit of cysts and the methodology for a safe and successful minimally invasive surgery has not been established.Here we report a case of a large 10-kg multi-locular ovarian mass,which was successfully laparoscopically removed:Our aim was to innovate the surgical practice in this field by providing a safe,effective,and minimally invasive management method for such complex and rare cases.CASE SUMMARY A 49-year-old nulliparous woman presented with abdominal distension,lasting from six Mo prior to admission;she reported worsening abdominal pain,abdominal swelling,and mild dyspnea.Imaging showed a presumed benign multi-locular(>10 locules)left ovarian cyst that measured about 30 cm in diameter.Based on the IOTA-ADNEX model the mass had a 27.5%risk of being a borderline or malignant tumor.The patient was successfully treated via a direct laparoscopic approach with salpingo-oophorectomy,followed by the external drainage of the cyst.Tumor spillage was successfully avoided during this procedure.The final volume of the drained mucinous content was 8950 L;the cyst wall,extracted through the minilaparotomy,weighed about 1200 g.The pathologic gross examination revealed a 24 cm×15 cm×10 cm mass;the histologic examination diagnosed a mucinous cystoadenoma.To our knowledge,this is the first case of a giant multi-locular ovarian cyst treated with a direct laparoscopy with salpingo-oophorectomy followed by external decompression.CONCLUSION Choosing the appropriate technique and surgeon skill are necessary for a safe and effective minimally-invasive approach of unique cases involving giant ovarian cysts. | Elisabetta Sanna Clelia Madeddu Luca Melis Sonia Nemolato Antonio Macciò | 2020 | World Journal of Clinical Cases2020，8，16： | 1 |
| 4 | 腹腔镜下全子宫切除术麻醉恢复期躁动的危险因素预测模型显示文摘目的研究腹腔镜下全子宫切除术患者麻醉恢复期躁动的危险因素并构建预测模型。方法选取在我院进行腹腔镜下全子宫切除术的200例患者为研究对象,根据Riker躁动、镇静评分标准,将≤4级的152例患者纳入无躁动组,将≥5级的48例患者纳入躁动组。对比2组患者的临床资料,分析影响腹腔镜下全子宫切除术患者麻醉恢复期躁动的相关因素;采用受试者工作特征(ROC)曲线分析相关因素对腹腔镜下全子宫切除术患者麻醉恢复期躁动的预测价值;Logistic多元回归模型分析影响腹腔镜下全子宫切除术患者麻醉恢复期躁动的独立危险因素;R语言软件4.0“rms”包构建预测腹腔镜下全子宫切除术患者麻醉恢复期躁动的列线图模型。结果与无躁动组相比,躁动组患者年龄较大,ASA分级Ⅲ级比例、术后留置导尿管比例、低氧血症比例、肌松药残留比例较高,采取术后镇痛比例较低,手术时间及麻醉时间较长,差异有统计学意义(P<0.05)。年龄、手术时间、麻醉时间的AUC分别为0.719、0.597、0.610,最佳截断值分别为55岁、83 min、93 min。年龄>55岁、ASA分级Ⅲ级、术后未镇痛、术后留置导尿管、低氧血症、肌松药残留是腹腔镜下全子宫切除术患者麻醉恢复期躁动的独立危险因素。列线图模型预测腹腔镜下全子宫切除术患者麻醉恢复期躁动的C-index为0.796(95%CI:0.613~0.867),阈值>0.19,列线图模型提供临床净收益率均高于独立预测因子。结论本研究基于年龄、ASA分级、术后镇痛、留置导尿管、低氧血症、肌松药残留构建了预测腹腔镜下全子宫切除术患者麻醉恢复期躁动的列线图模型,可用于麻醉恢复期躁动的早期预测及探查,防止躁动对患者造成损伤,确保安全。 | 周敏 严康明 周群英 李晓明 | 2023 | 局解手术学杂志2023，32，5： | 0 |
| 5 | Myomatous erythrocytosis syndrome:A case report显示文摘BACKGROUND Uterine myoma is the most common benign tumor among women and is often accompanied by anemia.Here,we report the case of a patient with a very large leiomyoma but with a hemoglobin level as high as 197 g/L.After undergoing hysterectomy,all her hematological parameters returned to normal.Immunohistochemical staining of her myoma for erythropoietin showed strong positivity,which suggested that erythropoietin may be the cause of her erythrocytosis.A multidisciplinary team played a significant role in treating the disease.CASE SUMMARY A 47-year-old woman visited our department complaining that her abdomen had been continuously growing for the past 2 years.After careful examinations,she was suspected of having a very large leiomyoma.She was also diagnosed with erythrocytosis because her RBC count was 6.49×10^(12)/L,hemoglobin was 197 g/L.Following a multidisciplinary team consultation,bilateral ureteral stents were placed,and 800 m L blood was removed by phlebotomy.The patient then underwent hysterectomy and bilateral salpingectomy.She recovered well from the operation,and her hemoglobin level decreased sharply following the surgery.Low-molecular-weight heparin was administered daily to prevent postoperative thrombosis.She was discharged from the hospital on the fourth postoperative day.Two months later,all her hematological parameters returned to normal.Pathological analysis of the myoma revealed that it was a benign leiomyoma,with partial hyalinization,and strong positivity for erythropoietin in immunohistochemical staining suggested that erythropoietin may be responsible for the erythrocytosis.CONCLUSION Erythropoietin ectopically produced from the myoma was responsible for the erythrocytosis in this patient.A multidisciplinary team is strongly recommended. | Xin-Yu Shu Na Chen Bi-Yun Chen Hui-Xia Yang Hui Bi | 2022 | World Journal of Clinical Cases2022，10，10： | 0 |
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