经腹小切口在大子宫肌瘤剔除术中的临床应用研究

Clinical application of mini-laparotomy myomectomy for large uterine fibroid

目的观察经腹小切口行肌瘤剔除术在治疗大子宫肌瘤中的临床应用疗效。方法回顾分析2010年1月至2011年12月收治的肌瘤直径≥8 cm的子宫肌瘤患者的临床资料,21例为研究组,行经腹小切口子宫肌瘤剔除术,与同期12例腹腔镜下肌瘤剔除术,35例经腹肌瘤剔除术进行对比,观察临床指标。结果研究组术中出血量、手术时间、术后复发率较经腹组差异无统计学意义,但术后肛门排气时间、住院费用较经腹组差异有统计学意义(P<0.01);研究组术中出血量、手术时间、住院费用、术后复发率与腔镜组差异有统计学意义(P<0.01,<0.05)但术后肛门排气时间与腹腔镜组无显著差异。结论经腹小切口行肌瘤剔除术优于经腹组,较腔镜组可以剔除体积更大、数目更多、生长部位更复杂的子宫肌瘤,是一种操作简单、容易掌握、值得推广的技术。

Objective To observe the clinical effects of mini - laparotomy myomectomy for large myoma of uterus. Methods Retro- spective analysis the clinical data of 68 patients who suffering from uterine fibroids which fibroids diameter ≥ 8cm from January 2010 to December 2011 in our hospital, in which, 21 cases for the study group, passing through mini - laparotomy myomectomy, compa,＇ed with 12 cases using laparoscopic myomectomy and 35 cases of laparotomy myomectomy patients at the same period, observed the clinical indicators. Results Compared with the laparotomy myomectomy group, there are no statistical difference in the blood loss, duration of operation and recurrence rate, but the results of postoperative anorectum exhaust time and hospital fees reduced significantly in study group. The results of blood loss, duration of operation, hospital fees and recurrence rate in study group are lower than the laparoscopic myomectomy group （ P 〈 0.05 ）, but there are no statistical difference in the results of postoperative anorectum exhaust time in two groups. Conclusion The clinical effects of mini -laparotomy myomectomy have more advantages than laparotomy myomectomy, can be excluded the uterine fibroid which have greater volume and number and more complex parts easier than laparoscopic myomectomy. This is a simple and easy -to -perform technique.