无气腹与气腹腹腔镜下子宫肌瘤剥除术的比较研究

Comparison of Myomectomy with Gasless Laparoscopy and Pneumoperitoneal Laparoscopy

目的:通过对无气腹腹腔镜子宫肌瘤剥除术与气腹腹腔镜子宫肌瘤剥除术对比分析,探讨无气腹腹腔镜子宫肌瘤剥除术的应用价值。方法:分析2011年9-12月实施无气腹腹腔镜子宫肌瘤剥除术14例患者的临床资料,并在同期施行气腹式腹腹腔镜子宫肌瘤剥除术病例中筛选条件相似的20例作为对照组。比较两组手术时间、术中出血量、手术并发症、术后胃肠功能恢复时间及住院时间。结果:两组手术均在腹腔镜下顺利完成,无中转开腹。无气腹组手术时间明显少于气腹组[(97.6±24.7)minVS(120.9±26.4)min](P<0.05)。无气腹组术中出血明量显少于气腹组[(227.4±84.5)mlVS(339.6±98.7)ml](P<0.05)。结论:与气腹腹腔镜子宫肌瘤剥除术相比,无气腹腹腔镜子宫肌瘤剥除术具有手术时间短、术中出血少、手术操作简便、手术并发症少、对患者循环呼吸影响小等优点。

Objective ：To compare the effectiveness of gasless laparoscopy and CO2-insuflated pneumoperitoneal iaparoseopy in myomectomy.Methods ： A total of 34 patients with uterine myoma were treated in our hospital from Sep 2011 to Dec 2011, gasless laparoscopy（GLM）was used in 14 patients and pneumoperitoneal laparoscopy（LM）were employed 20 cases.The operation time, intraoperative blood loss, surgical complications, postoperative recovery time of gastrointestinal function and hospital stay were compared between the two groups.Results ：The operation was completed in both the groups without intra-or post-operative complications occurred.Compared to the LM group, the GLM group had significantly shorter operation time[（97.6±24.7）min VS （120.9±26.4） mini（P〈0.05）, blood loss in operation[（227.4±84.5）ml VS （339.6±98.7）ml]（P〈0.05）.The recurrence rate was not significantly different between the two groups.Conclusion ： Compared to conventional laparoseopy gasless laparoscopy has an advantage of operative time, blood loss, complications.The effects of circulatory and respiratory is small in gasless laparoscopy.It is a good choice for myomectomy.