开腹与微创子宫肌瘤剔除术临床结局分析.pdfVIP

! 278! 2008 4 24 4 : 1005- 2216( 2008) 04 - 0278- 04 张庆霞, 朱 兰, 刘珠凤, 郎景和, 孙大为, 冷金花, 樊庆泊 : 评价开腹腹腔镜下及阴式子宫 瘤剔除术的优缺点和手术适应证 回顾分析北京协和医院 2005年 1月至 2006 年 6月同期行开腹子宫 瘤剔除术 81例腹腔镜下子宫 瘤剔除术 148例和阴式子宫 瘤 剔除术 10例的临床资料, 选出相匹配的组别分别进行比较, 分析其一般临床资料及围手术期资料特点 阴式组与相匹配的腹腔镜组比较:住院费用阴式组明显少于腹腔镜组[ ( 4 66 1 080)元 对 ( 6 187 45)元 ], 术后肛门排气时间阴式组明显短于腹腔镜组[ ( 148 26) h 对 ( 188 31) h], 差异有统计学意义 (P 005) 术后住院时间阴式组长于腹腔镜组[ ( 41 1 ) d 对 ( 26 0 ) d, P 005); 单发 壁间 瘤腹腔镜组与相匹 配的开腹组相比, 术后住院时间腹腔镜组明显短于开腹组 [ ( 32 0 ) d 对( 60 0 4) d], 术后病率和术后镇 痛药使用率腹腔镜组亦明显少于开腹组( 588% 对 4 118% , 882% 对 352 % ), 手术时间腹腔镜组明显长于开 腹组 [ ( 106 420)m in 对( 748 271) m in), 均P 005 腹腔镜下及阴式 瘤剔除术均为微创术式, 两种术式均安全可靠; 阴式 瘤剔除术住院费用更少, 对腹腔干扰更小, 而多发( 5 个)巨大或剔除术后复发的 瘤首选开腹 瘤剔除术 : 子宫 瘤剔除术; 腹腔镜; 阴式子宫 瘤剔除术 : R71 : A The ana ly sis of clin ica l outcom e of differen t w ay s of m yom ectom y. ZHANG Q ing x ia, ZH U L an, L IU Zhuf eng, LAN G J ing he, S UN D aw e i, LEN G J inhua, FAN Q ing bo. D ep ar m en of O bs e rics and Gynecology, P ek ing Union M edical C olleg e H osp i al, P ek ing Union M ed ical Co lleg e, Ch iniese A cademy of M edical Sc ience, B e ij ing 100730, Ch ina. A bstrac t O bj ective To analyze the advantages, disadvantages and ind ications of transabdom inal m yom ectomy ( TAM ), laparoscopicm yom ectomy( LM ) and transvaginalm ym ectom y(TVM ) . M ethods A total of 81 cases of TAM, 148 cases of LM and 10 cases of TVM w ere retrospectively assessed. R esu lts When Group TVM w as com paredw ith the comparab le group LM, it had significantly lower hosp italization cost, shorter tmi e of passage of gas by anus, but had longer hospital stay than the later. Group LM ( sigle intramural myom a) had sign ificantly shorter hospital stay, lower usage rate of painkiller, low er postoperative b lood loss, but longer operation