两种微创子宫肌瘤剔除术式疗效分析

Curative effect analysis of two minimally invasive myomectomy methods

目的评价两种微创子宫肌瘤剔除术的疗效及临床应用价值。方法回顾分析腹式子宫肌瘤剔除术80例(腹式组),腹腔镜子宫肌瘤剔除术45例(腹腔镜组),阴式子宫肌瘤剔除术40例(阴式组)的临床资料。对三组患者的手术时间、术中出血量、住院时间、术后排气时间、术后病率、住院费用进行对照分析。结果三组比较,手术时间差异无统计学意义(P>0.05);术中出血量、住院时间、术后排气时间腹式组较腹腔镜组及阴式组显著增多,差异有统计学意义(P<0.05);腹腔镜组术后病率较腹式组及阴式组明显降低,差异有统计学意义(P<0.05);阴式组与腹腔镜组比较,两组手术时间、术后排气时间、住院时间、术中出血量差异均无统计学意义(P>0.05);治疗费用明显少于腹腔镜组,差异有统计学意义(P<0.05)。结论微创子宫肌瘤剔除术具有创伤小、恢复快、术后并发症少等优点,具有良好的临床应用价值,两种术式不可替代。但从经济学角度出发,阴式手术更值得临床基层推广。

Objective To evaluate the curative effect and clinical value of two minimally invasive myomectomy methods. Methods A retrospective analysis was made on the clinical data of 80 cases undergoing transabdominal myomectomy （transabdominal group）, 45 cases undergoing laparoscopic myomeetomy （laparoseopic group）, and 40 cases undergoing transvaginal muomectomy （transvaginal group）. Operation time, intraoperative bleeding volume, hospital stays, postoperative evacuation time, postoperative morbidity, and hospitalization costs were compared and analyzed in the three groups. Results There was no statistically significant difference in the operation times of the three groups （P〈0.05）. The transabdominal group had more intraoperative bleeding volume, longer operative time and postoperative evacuation time than the laparoscopic group and transvaginal group, and the difference had statistical significance （P〈0.05）. The laparoscopic group had lower postoperative morbidity than the transabdominal group and transvaginal group, and the difference was statistically significant （P〈0.05）. In the comparison between the transvaginal group＇ and the laparoscopie group, there were no statistically significant differences in operation time, postoperative evacuation time, hospital stays, and intraoperative bleeding volume （P〉0.05）. The transvaginal group had lower hospitalization costs than the laparoscopic group, and the difference had statistical significant （P〈0.05）. Conclusion Minimally invasive myomeetomy has the advantages of small trauma, quick recovery, and few postoperative complications, and it contains good value in clinical application. These two methods cannot replace each other. From the perspective of economy, transvaginal myomectomy is more worthy of clinical promotion in primary level.