腔镜下子宫肌瘤剔除术与开腹手术的临床对比分析  

Clinical Comparative Analysis of Laparoscopic Myomectomy and Abdominal Myomectomy

作　　者：纪娜[1] 赵莉[1] 冯忻[1] 罗立梅[1] 梁婷[1] 庄晨玉 张丽华[1] 

机构地区：[1]南方医科大学中西医结合医院,广东广州510315

出　　处：《中国医学创新》2015年第26期42-45,共4页Medical Innovation of China

基　　金：2010年建设中医药强省立项资助课题(2010222)

摘　　要：目的：探讨腹腔镜下子宫肌瘤剔除术与开腹手术的临床治疗效果。方法：选取本院2012年12月-2014年12月接收的行实施腹腔镜下子宫肌瘤剔除手术的患者35例作为观察组,另选择本院往期实施开腹手术治疗的子宫肌瘤患者36例作为对照组,比较两组患者的手术情况及手术后并发症的发生情况。结果：观察组例患者均顺利完成腹腔镜子宫肌瘤剔除术,无一例中转开腹。术中患者均未出现副损伤、大出血等并发症。对照组患者手术过程均顺利,剔除肌瘤个数最多7个,最大直径20 cm,但20 cm肌瘤剔除术中失血量较多,输注红细胞悬液2 U。无术中损伤,1例术后不全肠梗阻,经保守治疗后痊愈。观察组患者的手术时间明显长于对照组,手术出血量及住院费用均明显少于对照组,肛门排气时间及住院天数均明显短于对照组,手术切口明显短于对照组,术后镇痛药物使用率明显低于对照组,比较差异均有统计学意义（P〈0.05）。两组患者均未见严重的并发症发生,观察组患者的切口全部甲级愈合,愈合率为100%,对照组患者有3例患者出现切口感染,经过相关处理后,均恢复正常。观察组患者出现并发症2例,对照组患者出现并发症5例,两组患者并发症发生率比较差异无统计学意义（P〉0.05）。术后病理回报均为子宫平滑肌瘤。术后随访患者术后1个月复查,此后每6个月随访一次。所有患者均在术后1~3个月恢复正常月经周期,B超检查子宫恢复正常大小。结论：在针对子宫肌瘤患者实施手术时,采用腹腔镜手术,对患者造成的创伤小,大大地减少了患者的痛苦,降低手术后并发症发生的概率,患者恢复更快,值得临床推广应用。Objective： To investigate the clinical therapeutic effects of lapar0scopic myomectomy and abdominal myomectomy.nethod ： 35 patients with laparoscopic myomectomy from December 2012 to December 2014 were selected as the observation group, 36 cases of uterine fibroids with open operation treatment in our hospital were selected as the control group.The operation condition and postoperative complications between the two groups were compared.Result： All patients in the observation group were successfully completed laparoscopic myomectomy, no transfer laparotomy.lntraoperative no vice injury occurred, such as bleeding complications.The operation process of control group were all smoothly, eliminated fibroid number up to seven, maximum diameter was 20 cm, but 20 cm fibroids of myomectomy had more blood loss, injected 2 U erythrocyte suspension.No intraoperative injury, 1 case of incomplete intestinal obstruction after operation and recovered after conservative treatment.The operation time of the observation group was significantly longer than the control group, operative blood loss and hospitalization expenses were significantly less than the control group, the anus exhaust time and hospitalization days were significantly shorter than the control group, the operative incision was significantly shorter than the control group, the usage rate of postoperative analgesia was significantly lower than the control group, the differences were statistically significant （ P〈0.05 ） .Two groups of patients were no serious complications occurred, the observation group of patients with all the grade A healing of incision, the healing rate was 100%.In the control group, there were 3 cases with wound infection, after the related treatment, all recovered to normal.There were 2 cases of complications in the observation group, and 5 cases in the control group, there was no statistically significant difference in the complication rate （ P〉0.05 ） .Postoperative pathological returns were uterine fibroids.The patients were fol

关 键 词：腹腔镜 子宫肌瘤 开腹手术 

分 类 号：R737.33[医药卫生—肿瘤]