子宫肌瘤的手术方式及相关因素分析

Explore myomectomy style change surgery and related factors

目的探讨分析子宫肌瘤的手术方式及相关因素。方法回顾性分析2010年6月至2014年6月间收治的90例接受子宫肌瘤剔除术患者的临床资料。按照随机数字表法将患者分为A组、B组与C组,每组30例,A组患者给予阴式剔除术,B组患者给予腹腔镜剔除术,C组患者给予腹式剔除术,观察三组患者的肌瘤情况、手术时间、术中出血量等临床指标。结果 A组患者与B组患者的肌瘤数目、最大肌瘤直径、肌壁肌瘤数目及浆膜下肌瘤数目差异无统计学意义(均P>0.05)。A组患者与C组患者的肌瘤数目、肌壁肌瘤数目及浆膜下肌瘤数目差异无统计学意义(均P>0.05)。A组患者与C组患者的最大肌瘤直径差异有统计学意义(P<0.05)。A组患者与B组患者的手术时间、术中出血量差异有统计学意义(均P<0.05)。A组患者与B组患者的术后排气时间、术后住院时间差异无统计学意义(P>0.05)。A组患者与C组患者的手术时间、术中出血量差异无统计学意义(均P>0.05)。A组患者与C组患者的术后排气时间、术后住院时间差异有统计学意义(均P<0.05)。结论阴式剔除术、腹腔镜剔除术以及腹式剔除术均可应用子宫肌瘤的手术治疗,只要掌握好其临床适应证均可取得显著的临床效果。

Objective To explore and analyze surgical changes and related factors. Methods From June 2010 to June 2014,90 cases admitted to accept myomectomy in Huantai County People＇s Hospital were enrolled in the study. The patients were divided into three groups according to the random number table： group A,group B and group C（ 30 cases in each group）. Group A received vaginal myomectomy;group B received laparoscopic myomectomy; group C were given abdominal myomectomy. The surgical time,the amount of bleeding and other clinical indicators were observed. Results There were no significant differences between group A and group B in the average number of fibroids,fibroids maximum diameter,the average number of the muscle wall and the number of subserosal fibroids（ t = 1. 34,P〉0. 05; t = 1. 45,P〉0. 05; t = 1. 29,P〉0. 05; t = 1. 30,P〉0. 05）. There were no significant differences between group A and group C in the average number of fibroids,the average number of the muscle wall and the number of subserosal fibroids（ t = 1. 57,P〉0. 05; t = 1. 28,P〉0. 05; t = 1. 86,P〉0. 05）. There was significant difference between group A and group C in the maximum diameter of the fibroids（ t = 5. 67,P〈0. 05）.There were significant difference between group A and group B in operative time,blood loss（ t = 3. 45,P〈0. 05; t = 5. 66,P〈0. 05）. There were no significant differences between group A and group B in the postoperative discharge time,postoperative hospital stay（ t = 1. 78,P〉0. 05; t = 1. 56,P〉0. 05）. There were no significant differences between group A and group C in the operative time and blood loss（ t = 1. 38,P〉0. 05; t = 1. 41,P〉0. 05）. There were significant differences between group A and group C in the postoperative discharge time,postoperative hospital stay（ t = 3. 45,P〈0. 05; t = 5. 66,P〈0. 05）. Conclusions Vaginal myomectomy,laparoscopic myomectomy and abdominal myomectomy can be applied during the surgical treatment of uterine fibroids,as long as the master curious clinical indications can achieve significant clinical effect.