腹腔镜下袋式子宫肌瘤切除术54例分析.docVIP

腹腔镜下袋式子宫肌瘤切除术54例分析 　　[摘要] 目的 探讨腹腔镜下袋式子宫肌瘤切除治疗多发性子宫肌瘤的临床效果及可行性。方法 腹腔镜组为54例多发性子宫肌瘤患者行腹腔镜袋式子宫肌瘤切除术，对照组为54例患者行经腹多发性子宫肌瘤切除，观察两组手术时间、术中出血量、术后排气时间、术后住院天数等情况。 结果 所有病例手术均获成功，无一例中转开腹，无手术并发症发生。腹腔镜组平均手术时间（118.35±2.98）min，术中出血（96.06±1.86）mL，术后排气时间（22.13±0.53）h ，术后住院天数（4.17±0.15）d。腹腔镜组术中出血少、术后肠功能恢复快、住院天数短，与开腹组比较差异有统计学意义（P0.05）。 结论 腹腔镜下袋式子宫肌瘤切除术是安全、可行的，扩大了腹腔镜子宫肌瘤切除术的手术指征。 　　[关键词] 腹腔镜；子宫肌瘤剔除术；子宫平滑肌瘤 　　[中图分类号] R4 [文献标识码] A [文章编号] 1674-0742（2015）04（c）-0047-03 　　[Abstract] Objective To investigate the feasibility of laparoscopic bag hysteromyoma resection. Methods Fifty-four patients with multiple uterine myomas undergoing laparoscopic myomectomy were analyzed. The patients were divided into two groups according to the surgical pathway， LM （1aparoscopic myomectomy） group and OM（open myomectomy） group. The clinical features such as the average operating time， blood loss， postoperative exhaust time and average time of hospital stay were compared among the two groups. Results All cases were performed successfully laparoscopically. No intra-operative laparotomy or complications occurred. The average operating time were （118.35±2.98）min and blood loss were （96.06±1.86）mL. The postoperative exhaust time and average time of hospital stay was （22.13±0.53）min and （4.17±0.15）d. The blood loss， postoperative exhaust time and average time of hospital stay in LM group were significantly less than those in OM group （P0.05）. Conclusions Laparoscopic bag hysteromyoma resection can be performed and the operation indication is enlarged. 　　[Key words] Laparoscopy； Myomectomy； Uterine fibroids 　　随着腹腔镜技术的不断提高及手术经验的积累，腹腔镜下子宫肌瘤剔除术逐渐成熟并广泛应用，但多发性子宫肌瘤因为手术操作时间长，瘤腔缝合止血困难，常常被列为腹腔镜手术的禁忌。为了满足多发性子宫肌瘤患者的微创要求，该研究对2012年1月―2013 年12月间该院疏浚的54例多发性子宫肌瘤患者进行腹腔镜袋式子宫肌瘤切除术，取得了满意的效果，现报道如下。 　　1 资料与方法 　　1.1 一般资料 　　随机选择2012年1月―2013 年12月在安徽省立医院妇产科因多发性子宫肌瘤需行腹腔镜子宫肌瘤切除术的患者54例，年龄（35.1±0.8）岁，肌瘤最大直径3～6 cm。分为腹腔镜袋式子宫肌瘤切除组（腹腔镜组）和经腹子宫肌瘤切除组（经腹组）各54例。两组年龄、子宫大小及肌瘤数目等方面比较差异无统计学意义（P 0.05）。所有患者均已婚已育且排除手术禁忌， 术前均经宫颈薄层液基细胞学（LCT）和（或）阴道镜检查或诊刮术