腹腔镜与开腹子宫肌壁间大肌瘤切除术比较  

A comparison between laparoscopic and open resection for large intramural hysteromyoma

作　　者：王彦[1] 王璇[1] 张丽华[1] 宋志云[1] 侯建青[1] 姜学强[1] 

机构地区：[1]山东省青岛医学院附属烟台毓璜顶医院妇科,烟台264000

出　　处：《中国微创外科杂志》2004年第6期496-497,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　评价腹腔镜子宫肌壁间大肌瘤切除术的临床价值。　方法　回顾分析 4 2例直径 6～ 10cm单发子宫肌壁间肌瘤病例 :腹腔镜组 2 4例 ,开腹组 18例。比较两组术中及术后情况。　结果　两组手术均获成功 ,无明显并发症发生。手术时间腹腔镜组 ( 89 0± 2 6 9)min显著长于开腹组 ( 6 3 3± 2 0 1)min(t =3 4 0 0 ,P =0 0 0 2 ) ;术中出血量腹腔镜组 ( 93 6±6 5 9)ml与开腹组 ( 10 0 0± 4 8 7)ml无统计学差别 (t=- 0 347,P =0 731) ;镇痛剂使用例数腹腔镜组 ( 2 /2 4 )显著低于开腹组( 9/18) ( χ2 =7 2 0 8,P =0 0 0 7) ;肛门恢复排气时间腹腔镜组 ( 2 3 5± 11 3)h显著低于开腹组 ( 32 0± 13 6 )h(t =- 2 2 11,P =0 0 33) ;术后病率腹腔镜组 ( 2 /2 4 )明显低于开腹组 ( 7/18) ( χ2 =4 0 33,P =0 0 4 5 )。　结论　腹腔镜子宫肌壁间大肌瘤切除术是安全可行的。与开腹手术相比 ,术后恢复快 ,术后病率低 ,术中出血量并未增加 ,但手术时间明显延长 ,与肌瘤较大取出费时有关。Objective To evaluate the clinical significance of laparoscopic resection for large intramural hysteromyoma. Methods A retrospective analysis was made concerning 42 cases of single intramural hysteromyoma as large as 6～10 cm in diameter: 24 cases underwent laparoscopic hysteromyomectomy and 18 cases received open resection. Intra- and post-operative parameters between the two groups were compared. Results All operations in the two groups were successfully completed without complications. The operative time was significantly longer in the laparoscopic group (89.0±26.9 min) than that in the open group (63.3±20.1 min) ( t=3.400,P =0.002). No statistical difference was observed in the intraoperative blood loss between the laparoscopic group (93.6±65.9 ml) and the open group (100.0±48.7 ml) ( t=-0.347, P=0.731) . The analgesic requirement was less in the laparoscopic group (2 out of 24 cases ) than that in the open group (9 out of 18 cases) ( χ 2 =7.208, P =0.007). The time to first flatus was shorter in the laparoscopic group (23.5±11.3 h) than that in the open group (32.0±13.6 h) ( t=-2.211, P =0.033). The postoperative pyrexia rate was significantly lower in the laparoscopic group (2/24) than that in the open group (7/18) ( χ 2=4.033, P =0.045). Conclusions Laparoscopic resection for larger intramural hysteromyoma is safe and reliable. As compared with open hysteromyomectomy, it offers more rapid recovery and lower postoperative pyrexia rate, as well as the same amount of blood loss. Its prolonged operative time may be associated with the relatively large size of the hysteromyoma.

关 键 词：腹腔镜 子宫肌瘤切除术 

分 类 号：R737.33[医药卫生—肿瘤]