子宫肌瘤剔除3种术式的临床比较

Clinical Comparison of Myomectomy by Three Surgical Methods

目的比较3种子宫肌瘤剔除术的临床效果和安全性。方法子宫肌瘤剔除术180例按手术方法不同分成3组:开腹子宫肌瘤术(TAM)60例、腹腔镜下子宫肌瘤剔除术(LM)60例和阴式子宫肌瘤剔除术(TVM)60例,比较手术效果和术后恢复情况。结果 TVM手术时间(69.58±26.72)min、TAM(88.93±31.07)均小于LM(115.63±35.12)min(t=2.345,t=2.241,P<0.05);TVM组术中出血量(100.33±87.04)mL均小于LM(143.31±141.42)、TAM(149.29±132.72)mL(t=2.235,t=2.241,P<0.05);TAM肛门排气时间(46.33±14.89)h均大于LM(38.23±10.22)、TVM(29.51±7.86)h(t=2.275,t=2.341,P<0.05);TAM术后体温恢复正常时间(2.01±1.49)d均大于LM(1.87±1.0)、TVM(1.75±1.62)d(t=2.315,t=2.341,P<0.05);TAM术后住院时间(8.12±1.46)d均大于LM(7.12±1.65)、TVM(6.35±1.27)d(t=2.375,t=2.441,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 compare clinical efficacy and safety of. three kinds vaginal myomectomy. Methods 180 cases of uterine myomectomy according to the different surgical methods were divided into 3 groups： 60 cases with transabdominal myomectomy （TAM）, 60 cases with laparoscopic myomectomy（LM） and 60 cases with transvaginal myemectomy（TVM）, to compare the effects of operation and recovery. Results The operative time（69.58 ± 26.72）min in TVM and （88.93±31.07）min in TAM were less than （115.63±35.12） in LM（t=2.345, t=2.241, P0.05）; The blood loss （100.33 ± 87.04）mL in TAM were less than the（143.31±141.42）mL in LM and （149.29 ± 132.72）mL in TAM （t=2.235, t=2.241, P0.05）; The anal exhaust time （46.33 ±14.89）h in TAM were greater than the（38.23±10.22）h in LM and（29.51±7.86）h in TVM（t=2.275, t=2.341, P0.05）; The time of body temperature returned to normal posto- perative（2.01±1.49）d in TAM were higher than（1.87±1.0）d in LM and（1.75±1.62）d in TVM（t=2.315, t=2.341, P0.05）; The time of hospital stay（8.12 ±1.46）d in TAM were higher than（7.12±1.65）d in LM and（6.35±1.27d in TVM（t=2.375, t=2.441, P0.05）.Conclusion TVM could be performed in selected patients because it shows several advantages：including good safety, less trauma, less pain, quick recovery, low complications.