子宫肌瘤剔除术三种术式临床效果比较  

Clinical Comparison of Three Ways of the Hysteromyomectomy

作　　者：吴国英[1] 章颖[1] 袁桂兰[1] 吕华[1] 冯志娟[1] 金玲[1] 

机构地区：[1]北京市海淀医院妇产科,100080

出　　处：《中国计划生育学杂志》2008年第7期428-430,共3页Chinese Journal of Family Planning

摘　　要：目的:比较开腹、阴式、腹腔镜下3种途径子宫肌瘤剔除术的优缺点。方法:回顾分析开腹子宫肌瘤剔除术42例(开腹组)、阴道子宫肌瘤剔除术26例(阴式组)和腹腔镜下子宫肌瘤剔除术25例(腹腔镜组)的临床资料。结果:阴道组手术时间最短(84.2±29.8min),开腹组次之(102.7±30.8min),腹腔镜组手术时间最长(129.6±39.7min),3组间比较差异有统计学意义(P<0.05)。术中出血量阴式组最少(122.3±44.1ml),与开腹组、腹腔镜组比较差异有统计学意义(P<0.05)。肌瘤最大直径开腹组最大(8.0±2.8cm),与腹腔镜组、阴式组比较差异有统计学意义(P<0.05)。术后排气时间阴式组最短(21.0±4.8h),腹腔镜组次之(24.4±5.1h),开腹组时间最长(30.5±4.7h),3组间比较差异有统计学意义(P<0.05)。术后病率3组间比较差异无统计学意义(P>0.05)。术后住院时间开腹组时间最长(7.5±1.1d),与阴式组、腹腔镜组比较差异有统计学意义(P<0.05)。结论:腹腔镜下子宫肌瘤剔除术、阴式子宫肌瘤剔除术具有手术创伤小、术后恢复快等优点,而开腹子宫肌瘤剔除术适应证范围更广,3种术式不能完全互相替代。Objective： To compare the advantages and disadvantages of transabdominal myomectomy （TAM）, transvaginal myomectomy（TVM） and laparoscopic myomectomy（LM）. Methods： The clinical data of 42 cases of TAM （group TAM）, 26 cases of TVM （ group TVM） and 25 cases of LM （ group LM ） were retrospectively reviewed. Results ： The operation time of the group TVM was the shortest （84.2min ±29.8min）, the group TAM occupied longer time than the group TVM（ 102.7min ±30.8min ）, and the group LM occupied the longest time （ 129.6min ± 39.7min）. There were significant differences among the three groups （P 〈0.05）. The intraoperation hemorrhage volume was significantly less in the group TVM（ 122.3 ±44.1 ） mL than that in the group TAM and the group LM （ P 〈 0.05 ）. About the longest diameter of the myomas, the group TAM was arranged the first place（ 8.0 ± 2.8） cm which was significantly longer than the that of the other two groups. About the time of gas passage by anus, the group TVM occupied the shortest time（21.0 ± 4.8）h, the group LM occupied longer time than the group TVM （ 24.4 ± 5.1 ） h, and the TAM occupied the longest time （ 30.5 ± 4.7 ） h. There was significant differences among the three groups （ P 〈 0.05 ）. As to the post - operative morbidity, there was no statistical difference. The length of stay of the group TAM （7.5 ± 1.1 ） d was significantly longer than that of the other two groups. Conclusion： Both LM and TVM have advantages of micro - invasion and rapid recovery, but TAM has a great variety of indications, which could not entirely supersede each other.

关 键 词：子宫肌瘤剔除术 阴式 腹腔镜 开腹 

分 类 号：R737.33[医药卫生—肿瘤] R169.42[医药卫生—临床医学]