腹腔镜下困难性子宫肌瘤剥除术经验  

The experience-sharing of difficult laparoscopic hysteromyomectomy

作　　者：陈丽静[1] 许峰[1] 凌静[1] 谭洁[1] 张晨霞[1] 吴群英[1] CHEN Lijing;XU Feng;LIGN Jing;TAN Jie;ZHAGN Chenxia;WU Qunying(Department of Gynecology, Jiangyin People's Hospital,Jiangyin 214400,China)

机构地区：[1]江苏省江阴市人民医院妇科,江苏江阴214400

出　　处：《中国医药科学》2018年第4期78-82,共5页China Medicine And Pharmacy

基　　金：江苏省无锡市重大项目/锡卫科教[2014]11号

摘　　要：目的探讨腹腔镜下困难性子宫肌瘤剥除术的可行性及临床治疗效果。方法回顾性分析2013年12月~2015年12月在我院妇科行困难性子宫肌瘤剥除术的临床资料患者60例(A组)的临床资料,随机选择我院同期行开腹困难性子宫肌瘤剥除的80例(B组)的临床资料,以及选择我院同期行腹腔镜下普通子宫肌瘤剥除的200例(C组)的临床资料进行比较,比较三组的手术治疗效果。结果三组手术时间、术中出血量、肛门恢复排气时间、住院时间、肠粘连发生率、肠梗阻发生率、术后病率、术后切口愈合不良发生率、患者满意率比较,差异有统计学意义(P<0.05);三组中转开腹率、副损伤发生率、皮下气肿发生率比较,差异均无明显统计学意义(P>0.05);三组术后妊娠率、残瘤率、术后复发率比较,差异无明显统计学意义(P>0.05)。结论与腹腔镜下普通子宫肌瘤剥除及开腹困难性子宫肌瘤剥除术相比,腹腔镜下困难性子宫肌瘤剥除术手术时间较长,术中出血量稍多,但未增加手术风险及并发症,具有创伤小、恢复快等优点,值得临床推广应用。Objective To discuss the feasibility and clinical therapeutic effects of difficult laparoscopichysteromyomectomy. Methods Sixty cases of undergoing difficult hysteromyomectomy in the gynecology of ourhospital from January 2013 to December 2015 which were selected as group A were analyzed retrospectively;80cases of undergoing difficult abdominal hysteromyomectomy in our hospital at the same period were randomlyselected as group B and 200 cases of undergoing normal laparoscopic hysteromyomectomy in our hospital at the sameperiod were selected as group C,the surgical results of the three groups were compared. Results The comparison ofoperation time,intraoperative blood loss,anal exsufflation time,hospitalization time,intestinal adhesion rate,intestinalobstruction rate,postoperative morbidity,the incidence of poor wound healing and patient satisfaction rate of thethree groups showed significant difference(P < 0.05);The comparison of conversion rate,the incidence of secondaryinjury and subcutaneous emphysema of the three groups was no significant difference(P > 0.05);The comparisonof postoperative pregnancy rate, residual tumor rate and recurrence rate of the three groups was no significantdifference(P > 0.05). Conclusion In comparison to normal laparoscopic hysteromyomectomy and difficultabdominal hysteromyomectomy,difficult laparoscopic hysteromyomectomy require longer operation time and have moreintraoperative blood loss,but doesn't increase the operative risk and postoperative complications.It has the merits oflittle trauma and rapid recovery and is worthy of being widely applied in clinic.

关 键 词：腹腔镜 腹腔镜检查 子宫肌瘤剥除术 困难性 

分 类 号：R737.33[医药卫生—肿瘤]