腹腔镜下子宫肌壁间肌瘤剔除术对妊娠的影响

Influence of Laparoscopic Muscle Intramural Uterine Fibroids Out of Pregnancy

目的探讨下子宫肌壁间肌瘤剔除术对妊娠的影响。方法自2008-01-2010-12行腹腔镜子宫肌壁间肌瘤摘除术的年轻患者50例，并随机选择同期行开腹手术子宫肌壁间肌瘤摘除患者50例，记录两组患者术后妊娠人数、妊娠时间、孕周、平均子宫大小、并统计妊娠并发症的发生，以研究腹腔镜下子宫肌壁间肌瘤剔除对患者术后妊娠的影响。结果所有患者均成功手术，腹腔镜组平均手术时间及术中出血量均低于开腹手术组，腹腔镜组患者共50例，术后妊娠人数38例，平均妊娠时间为1．5年，38例妊娠患者中，足月产35例，早产3例，顺产4例．剖宫产34例；开腹手术组患者共50例，术后妊娠人数40例，平均妊娠时间为1．6年，40例妊娠患者中，足月产37例，早产3例，顺产4例，剖宫产36例。2组患者术后妊娠人数、妊娠时间、孕周、平均子宫大小、前置胎盘的发生相比较无明显差异，其中P〉0．05。结论腹腔镜手术创伤小，术后患者恢复快，对于少量、中等大小肌瘤而无其它不孕原因的患者是一个较好的选择。

Objective To study the muscle intramural uterine myoma eliminating the influence of art on pregnan- cy. Methods Laparoscopic muscle intramural uterine fibroids enucleation of 50 cases of young patients, and randomly selected rows over the same procedure of 50 patients with muscle intramural uterine flesh tumour excision, record the number of two groups of patients with postoperative pregnancy, pregnancy, gestational age, the average size of the ute- rus, pregnancy complications, and statistics to study laparoscopic muscle intramural uterine fibroids to eliminate the im- pact on the postoperative patients with pregnancy. Results All patients were successful surgery, the average operation time and intraoperative blood loss of laparoscopic group were lower than open surgery group. The number of 2 groups of patients with postoperative pregnancy, pregnancy, gestational age, the occurrence of the average size of the uterus and placenta previa compared with no significant difference （ P 〉 0.05 ）. Conclusions Laparoscopic surgery trauma little, quicker recovery of patients, for small and medium size fibroids without other causes of infertility of patients is a better choice.