子宫肌瘤剔除行腹腔镜手术与开腹手术的临床比较

Myomectomy by laparoscopic surgery and laparotomy: a clinical comparison

目的比较腹腔镜与开腹子宫肌瘤剔除术的临床疗效及应用价值。方法回顾分析我院2009年1月～2011年12月间所行子宫肌瘤剔除手术91例患者的临床资料,其中有42例腹腔镜下手术(腹腔镜组)和49例剖腹手术(开腹组),分析2组患者手术时间、术中出血量、术后恢复情况。结果子宫肌瘤≤6 cm者,腹腔镜组的手术时间、术中出血量均显著少于开腹组(P<0.05),而肌瘤为7～8 cm者,2组的手术时间、术中出血量差异无统计学意义(P>0.05);而术后下床活动时间、肛门排气时间、恢复家务劳动时间及术后住院时间腹腔镜组均较开腹组缩短(P<0.01)。结论腹腔镜下子宫肌瘤剔除术具有创伤小、术后恢复快以及住院时间短等优点,值得临床推广应用。

Objective To explore the clinical value of myomectomy by laparoscopic surgery and laparotomy. Methods Clinical data of 91 patients from our hospital were collected who underwent myomectomy {42 by laparoscopic surgery and 49 by laparotomy） between January 2009 and December 2011 and retrospectively analyzed in terms of their operation time span,intraoperative blood loss and postoperative recovery. Results For those with myoma of uterus ≤ 6cm, the operation time span of the laparoseopic group was significantly shorter and intraopera tire blood loss significantly less than that of the laparotomic group （ P 〈 0 05 ）. But for cases with myoma of uterus 7 - 8cm, the two groups demonstrated no statistical significance in operation time span and amount of blood loss （ P 〉 0.05 ）. The time needed for postoperative ambulation, anal exhaustion, housework recovery and postoperative hospitalization was considerably shortened in the laparoscopic group （ P 〈 0 01 ）. Conclusion Laparoseopic myomectomy is characteristic of less trauma, faster postoperative recovery and shorter hospitalization. It is worth to be recommended for clinical application.