子宫肌瘤腹腔镜剔除术及开腹手术比较探究.doc

子宫肌瘤腹腔镜剔除术及开腹手术比较探究[摘要] 目的 比较腹腔镜下与开腹子宫肌瘤剔除术的临床效果。方法 回顾分析47例腹腔镜手术和39例开腹手术子宫肌瘤患者的临床资料，比较两组术中和术后情况。结果 腹腔镜组的肌瘤剔除个数、术中出血量、术后体温恢复正常时间、肛门排气时间、下床活动时间、术后住院日、术后并发症发生率均显著低于开腹组（P＜0.05或P＜0.01）。结论 两种手术方法各有优缺点，但对于肌瘤个数不多的患者腹腔镜手术更适合。 [关键词] 子宫肌瘤；剔除术；腹腔镜；开腹 [中图分类号] R737.33 [文献标识码] B [文章编号] 1673-9701（2011）24-157-02 Comparing the Clinical Outcome of Laparoscopic Myomectomy and Abdominal Myomectomy of Hysteromyoma GUO Jinfang QI Weizhen Department of Gynecology of Dongyang City People’s Hospital in Zhejiang Province，Dongyang 322100，China [Abstract] Objective To compare the clinical outcome of laparoscopic myomectomy and abdominal myomectomy of hysteromyoma. Methods Do retrospective analysis of 47 patients of hysteromyoma underwent laparoscopic myomectomy and 39 patients of hysteromyoma underwent abdominal myomectomy. Compared the operative duration and postoperative recovery of two groups. Results The number of myoma，intraoperative blood loss，postoperative recovery time of body temperature，time of passage of gas by anus，off-bed activity，postoperative hospital stay and complication rate of laparoscopic myomectomy group were significantly shorter than those of abdominal myomectomy group（P＜0.05 or P＜0.01）. Conclusion Two kinds of surgical method have their advantages and disadvantages. But for patients with not much fibroids，laparoscopic surgery is more suitable. [Key words] Hysteromyoma；Myomectomy；Laparoscope；Abdominal 子宫肌瘤是常见的妇科生殖器官的良性肿瘤，临床上多采用手术方法进行治疗。当前，子宫肌瘤剔除术的方法主要有开腹手术和腹腔镜下剔除术。当前，随着腹腔镜技术的广泛应用，腹腔镜下子宫肌瘤剔除手术越来越多。本文对子宫肌瘤的腹腔镜剔除术和开腹手术进行比较研究，现报道如下。 1 资料与方法 1.1 一般资料 将2010年我院妇产科住院行开腹手术和腹腔镜剔除术治疗的86例子宫肌瘤患者作为研究对象。年龄26～46岁，平均（38.5±3.7）岁。其中未婚8例，已婚78例；足月分娩史者5例，有自然流产史者81例；单发肌瘤37例，多发肌瘤49例；宫体肌瘤71例，宫颈肌瘤15例。71例宫体肌瘤中，62例为浆膜下和肌壁间肌瘤，6例为浆膜下肌瘤，3例为黏膜下肌瘤合并肌壁间肌瘤。肌瘤的直径为1～10cm，平均5.4cm。将86例子宫肌瘤患者根据住院手术情况进行分组，其中开腹手术组39例，腹腔镜剔除术组47例。两组患者的年龄、足月分娩史比例以及肿瘤生长部位的差异均无统计学意义（P＞0.05）。 1.2 手术方法 1.2.1 开腹手术 采用连续硬膜外或腰硬联合麻醉方法进行麻醉。患者取膀胱截石位，进行常规消毒、铺巾、导尿。常规开腹，进入腹腔，在肌瘤突出处切开肌层，参照苏应宽等主编的《妇产科手术学》子宫肌瘤剔