阴式子宫肌瘤剔除术可行性和安全性分析

Evaluating the feasibility and safety of vaginal myomectomy

目的探讨阴式子宫肌瘤剔除术的可行性和安全性。方法回顾性分析北京协和医院2005年1月至2011年12月行阴式子宫肌瘤剔除术的49例患者的临床资料,记录患者手术适应证及围手术期相关参数。结果患者手术时间(64.8±20.2)min,术中失血量和住院时间分别为(75.6±56.6)mL、(4.8±1.6)d。其中6例(12.2%)患者出现术后病率,术后病率与手术创伤、手术时间、肿瘤大小呈显著相关性(P<0.01)。患者平均手术费用(796.6±320.1)元人民币,总医疗费用(4760.2±1094.6)元人民币。结论对适应证选择恰当的阴式子宫肌瘤剔除术是一种安全并且经济的手术方法。

Objective This study was designed to evaluate the feasibility of vaginal myomectomy. Methods Between January 2005 and December 2011,49 patients with symptomatic myomas were admitted for vaginal myomectomy in Peking Union Medical College Hospital （PUMCH）. The indications, operative performance, postoperative complications and outcome of these patients were analyzed retrospectively. Results Myomectomy was performed vaginally in all patients. The mean operating time was （64. 8 ±20. 2） minutes and the mean operative blood loss and hospital stay were （75.6±56. 6） mL and （4. 8 ±1.6） days,respectively. Six （ 12. 2% ） patients developed febrile morbidity and experienced a high post- operative temperature. Postoperative fever was associated with greater operative trauma,longer operative time and greater weight of the tumor （ all P 〈 0. 01 ）. The cost of surgery was RMB （796. 3±320. 1 ） Yuan and the total medical cost was RMB （4760. 2±1094. 6） Yuan. Conclusion Vaginal myomectomy is a feasible and safe surgical procedure.