3种途径子宫肌瘤剔除术的临床观察

Clinical observation of three ways of the hysteromyomectomy

目的比较3种子宫肌瘤剔除术的临床效果和安全性。方法回顾性分析2007年1月至2008年12月间本院阴式子宫肌瘤剔除术患者32例(阴式组)、同期腹式子宫肌瘤剔除术45例(开腹组)与腹腔镜子宫肌瘤剔除术29例(腹腔镜组)患者的临床资料,比较手术效果和术后恢复情况。结果开腹组手术时间最短(93.13±27.38)min,与腹腔镜和阴式组比较差异有统计学意义(P<0.05);术中出血量阴式组最少(125.25±100.30)mL,与开腹组、腹腔镜组比较差异有统计学意义(P<0.05);术后排气时间阴式组最短(22.62±6.65)h,3组间比较差异有统计学意义(P<0.05);术后镇痛阴式组最少(9.37%),3组间比较差异有统计学意义(P<0.05);阴式组与腹腔镜组比较,手术时间、术后最高体温、起床活动时间、住院天数、体温恢复正常时间两组间差异无统计学意义(P>0.05)。结论阴式子宫肌瘤剔除术安全、有效、创伤小,术后疼痛轻,并发症少,恢复快,是一种值得推广的微创手术。

Objective To evaluate the feasibility,clinical effect and safety of vaginal myomectomy. Methods To compare the effects of operation and recovery, retrospectively analysis were done on the clinical data of 32 cases of transvaginal myomectomy （TVM） ,45 cases of abdominal myomectomy（TAM） and 29 cases of laparoseopic myomectomy（LM） From January 2007 to December 2008 in our hospital. Results The mean operation time was significantly shorter in the group TAM （93.13±27.38）min than that in the group LM and group TVM（P〈0.05） ;The intraoperation hemorrhage volume was significantly less in the group TVM （125.25±100.30）mL than that in the group TAM and the group LM （P〈0. 05） ; About the time of gas passage by anus, the group TVM occupied the shortest time（22.62± 6.65）h and the cases need to relieve pain were the least （9.37%）, there were sig- nificant differences among the three groups（P〈0.05） ; The mean operation time, the highest temperature after operation, the active time after get up, hospitalization days and temperature recovery time, there was no difference between group TVM and group LM（P〉0.05）. Conclusion TVM could be performed in selected patients because it shows several advantages：including good safety,less trauma, less pain, quick recovery, low complications.