术前准备时间对子宫肌瘤患者手术疗效的影响

Influence of preoperative preparation time on surgical efficacy in patients with hysteromyoma

目的探讨术前准备时间对子宫肌瘤患者手术疗效的影响。方法选择2010年2月～2012年2月于湖北省京山医院因子宫肌瘤行子宫切除患者200例为研究对象,分为研究组和对照组,每组各100例,研究组术前准备1 d,对照组常规术前准备3 d。比较两组患者手术时间、术中出血量,术后体温恢复时间、肛门排气时间、术后镇痛药使用、C反应蛋白(CRP)、白细胞计数、住院天数、住院费用及手术并发症情况。结果研究组手术时间为(76.43±28.12)min,术中出血量为(85.10±36.13)mL,对照组手术时间为(78.50±30.28)min,术中出血量为(87.24±38.12)mL,研究组与对照组比较,差异均无统计学意义(均P>0.05)。研究组术后体温恢复时间为(32.72±4.27)h,肛门排气时间为(25.4±3.31)h,术后镇痛药物使用率为10.0%(10/100),白细胞计数为(6.81±1.61)×109/L,CRP为(5.82±1.67)mg/L,对照组术后体温恢复时间为(40.16±5.73)h,肛门排气时间为(33.62±4.25)h,术后镇痛药物使用率为15.0%(15/100),白细胞计数为(10.00±2.37)×109/L,CRP为(9.45±3.68)mg/L,研究组与对照组比较,差异均有统计学意义(均P<0.05)。研究组无并发症发生,对照组出现1例腹部切口感染。研究组住院时间[(8.57±1.91)d]、住院费用[(3587.41±231.28)元]均低于对照组[(10.45±1.74)d、(3978.62±325.37)元],差异均有统计学意义(均P<0.05)。结论子宫肌瘤术前准备1 d后进行手术,可缩短患者的住院时间,减少患者的住院费用,为子宫肌瘤患者最佳手术时机的选择提供瘤子宫全切围术期临床路径。

Objective To investigate the influence of preoperative preparation time on surgical efficacy in patients with hysteromyoma. Methods 200 patients with hysteromyoma in Jingshan Hospital of Hubei Province from February 2010 to February 2012 were selected and divided into research group and control group with 100 cases in each group. Patients in research group were asked to prepare for 1 day before the operation, patients in research group were asked to prepare for 3 days before the operation. Operation time, intraoperative blood loss, recovery time of postoperative body temperature, anus exhaust time, the usage of postoperative analgesic, C reactive protein, white cell count, length of stay, hospital costs and operation complications were compared in the two groups. Results Operation time in research group were （76.43±28.12） min and intraoperative blood loss in research group were （85.10±36.13） mL, operation time in control group were （78.50_±30.28） min and intraoperative blood loss in control group were （87.24±38.12） mL, the differences were not statistically significant between the two groups （P 〉 0.05）. Recovery time of postoperative body temperature in research group were （32.72±4.27） h, anus exhaust time in research group were （25.4±3.31） h, the usage of postoperative analgesic in research group was 10.0% （10/100）, white cell count in research group were （6.81±1.61）x 10/L, C reactive protein in research group were （5.82±1.67） mg/L,：recovery time of postoperative body temperature in control group were （40.16±5.73） h, anus exhaust time in control group were （33.62±4.25） h, the usage of postoperative analgesic in control group was 15.0% （15/100）, white cell count in control group were （10.00±2.37）x109/L, C reactive protein in control group were （9.45±3.68） rag/L, the differences were all statistically significant （P 〈 0.05） between the two groups. No operation complication was found in research group, 1 case of abdominal incision infection was found in control group. Length of stay and hospital costs in research group [（8.57±1.91）d, （3587.41±231.28） yuan] were all lower than those in research group [（10.45±1.74）d, （3978.62±325.37） yuan], the differences were all statistically significant （P 〈 0.05）. Conclusion Taking hysteromyoma operation 1 day after the preoperative preparation can shorten the hospitalization time, reduce the cost of hospitalization, provide perioperative clinical pathway for the optimal timing of surgerical selection in hysteromyoma patients.