开腹与腹腔镜下子宫肌瘤剔除术治疗子宫肌瘤的疗效比较

Comparison of clinical effect of laparoscopic myomectomy and trans-abdominal myomectomy

目的比较子宫肌瘤患者采用腹腔镜和开腹子宫肌瘤剔除术的临床疗效。方法回顾性分析2010年1月至2012年12月宁波开发区中心医院收治的子宫肌瘤患者200例的临床资料,按照手术方式分为腹腔镜组(LM组)和开腹手术组(TAM组),比较两组患者术中及术后情况。结果 LM组手术时间显著长于TAM组(t=20.623,P<0.01),但术中出血量显著少于TAM组(t=12.040,P<0.01);术后LM组平均排气时间、平均住院时间均显著短于TAM组短(t值分别为9.126、12.235,均P<0.01),但两组术后3天体温比较无统计学差异(t=0.576,P>0.05);LM组术后2例出现尿潴留,TAM组有5例并发症发生,其中2例出现肌瘤剔除后局部血肿,2例出现切口感染,1例尿潴留,两组患者术后并发生比较无统计学差异(x^2=1.332,P=0.248),且肌瘤复发情况无统计学差异(x^2=2.509,P=0.113)。结论腹腔镜下子宫肌瘤剔除术安全有效,值得临床上推广应用。

Objective To compare the clinical effect of laparoscopic myomectomy （ LM ） and trans-abdominal myomectomy （ TAM ） . Methods A retrospective analysis was conducted on the clinical data of 200 patients with uterus myoma admitted during the period of January 2010 to December 2012 in Ningbo Development Zone Center Hospital.The cases were divided into LM group and TAM group, and the intraoperative and postoperative conditions were compared between two groups.Results The operation time in LM group was significantly longer than that in TAM group （t=20.623,P〈0.01）, but intraoperative blood loss was significantly less than that in TAM group （t=12.040,P〈0.01） .The average exhaust time and average length of hospital stay were significantly shorter than those in TAM group （ t value was 9.126 and 12.235, respectively, both P〈0.01）, but there was no significant difference in body temperature between two groups 3 days after operation （t=0.576,P〉0.05）.In LM group there were 2 cases with postoperative urinary retention.In TAM group there were 5 cases with complications, including 2 cases with local hematoma after myomectomy, 2 cases with incision infection and 1 case with urinary retention.There were no significant differences in complications and recurrence of uterus myoma between two groups （χ^2 value was 1.332 and 2.509, respectively;P value was 0.248 and 0.113, respectively）.Conclusion LM is safe and effective, which is worthy of clinical application.