阴式与腹式子宫肌瘤切除术临床分析

Clinical Analysis of Transvaginal Myomectomy and Abdominal Myomectomy

目的比较经阴道子宫肌瘤剔除术(TVM)和腹部子宫肌瘤剔除术(TAM)之间的结果,并提供有价值的信息选择子宫肌瘤切除术的术式。方法比较54例腹部子宫肌瘤剔除术(TAM)和60例经阴道子宫肌瘤剔除术(TVM)的结果,包括手术时间、出血量、手术后排气时间、住院时间和盆腔感染率。结果经阴道组平均手术时间(58.3±7.7)min,显著缩短(P<0.05),TVM组的术中平均出血量(96.5±17.8)ml少于TAM组(112.4±30.7)ml(P<0.05),术后排气时间TVM组(18.9±6.8)h比TAM组(25.1±7.1)h短,住院时间TVM组(6.5±1.3)d和TAM组(8.9±1.4)d比较亦差异有统计学意义(P<0.05)。但TVM组盆腔感染率(18.3%)高于TAM组(3.7%),相比差异有统计学意义(P<0.05)。结论经阴道子宫肌瘤剔除术具有微创,出血少,术后恢复快,住院时间短。然而这两种方法有各自的优点和适应症,它们不能完全替代对方。

Objective To compare outcomes between transvagihal myomectomy（TVM）and abdominal myomectomy（TAM）,and to provide valuable information for choosing the approach of myomectomy.Methods Total 54 cases of TAM and 60 of TVM enrolled in this study,the operative time,bleeding loss,discharge after operation,hospitalized time and pelvic infection were compared between the two groups.Results The mean operative time of TVM group（58.3±7.7）min was shorter（P0.05）,the mean intraoperative hemorrhage of TVM group（96.5±17.8）ml were less（P0.05）,and the postoperative anal exhaust time of TVM group（18.9±6.8）h was shorter（P0.05） as compared to TAM group.The difference in hospitalized time and rate of pelvic infection（18.3% in TVM group vs.3.7% in TAM group） were statistically significant P0.05.Conclusion TVM has advantages of minimal invasion,less blood loss,rapid postoperative recovery and short hospitalization as compared to TAM.However,the two approaches had their own characters and indications,and cannot be substituted for each other.