经阴道子宫肌瘤剔除术86例临床分析

Vaginal myomectomy-analysis of 86 cases

目的 探讨经阴道子宫肌瘤剔除术的可行性、效果和安全性。方法 探讨经阴道子宫肌瘤剔除术患者的手术适应证、并发症、术后恢复情况，并与同期经腹腔子宫肌瘤剔除术相比较。结果 86例符合经阴道子宫肌瘤剔除术适应证，拟行经阴道手术，其中83例（96％）成功的经阴道剔除了子宫肌瘤；切除肌瘤数目中位数2个；子宫大小中位孕10周（孕8～16周大小）；平均手术时间52min；平均术中出血230ml；平均术后最高体温38．4℃；平均术后住院日7天；随访12个月复发率1％。经阴道子宫肌瘤剔除术术后体温高于同期经腹腔肌瘤剔除术，但一般24～48h恢复，其他参数相比较差异无统计学意义。结论 已婚育龄妇女经阴道子宫肌瘤剔除基本可以替代经腹腔途径。

Objective To investigate the feasibility,operation outcome and safety of a new route of myomectomy vaginal myomectomy. Methods Myomectomy by vaginal route was compared with laparotomic route in respective of indication, operative performance, surgery complication and postoperative recovery. Results In the 86 women who met the indication of vaginal myomectomy,83 （96%） cases successfully undertook vaginal routine. The median resection tumor number of vaginal myomectomy was 2. The median size of patients＇ uterus was 10 gestational weeks （range from 8 to 16 gestational weeks）. The mean operating time was 52 minutes. The mean intraperative blood loss was 230ml. The mean top postoperative temperature was 38.4℃. The average postoperative hospital stay was 7 days. There was no uterine hematomas developed in all 86 patients via vaginal route. After follow-up of 12 moths,there were 1% recurrence in all cases. When compared with laparotomic myomectomy, there were no signifi cant difference in above all respect except for postoperative temperature , but the temperature usually lasted shorttime,only about 24-48 hours. Conclusion Vaginal myomectomy can be an alternative surgery method to laparotomic myomectomy.