不同手术方式对子宫肌瘤的机体创伤及安全性分析

Effect of different surgical treatment on the body trauma and the safety in uterine fibroids of trauma

目的探讨不同手术方式对子宫肌瘤的机体创伤及安全性。方法选取126例子宫肌瘤患者,按照手术方式的不同分为对照组和治疗组,各63例。对照组患者采用传统开腹手术,治疗组患者采用腹腔镜下子宫肌瘤切除术。观察两组患者的术后恢复、疼痛和不良反应情况,并观察术后瘤体体积变化情况。结果两组患者治疗后一般状况良好,但治疗组患者术后住院时间为(3.4±1.6)d,下床时间为(1.3±0.6)h,阴道出血时间为(3.1±0.9)d,均显著短于对照组的(7.3±1.7)d,(46.8±11.2)h,(11.7±5.3)d,差异均有统计学意义(均P<0.05);治疗组患者术后6 h和24 h疼痛评分均显著优于对照组,差异均有统计学意义(均P<0.05);但术后72 h疼痛评分在各组间差异均无统计学意义(均P>0.05);治疗组术后的不良反应发生率为23.8%,显著少于对照组的49.2%,差异有统计学意义(P<0.05);术后随访6个月发现,治疗组的瘤体体积显著缩小,但对照组部分患者仍发现瘤体的增长。结论尽管腹腔镜下子宫肌瘤切除术未完全切除瘤体,但整体上改变了瘤体的大小,且术后患者恢复快,创伤小,安全性高,值得临床进一步推广。

Objective To explore the effect of different surgical treatment on the body trauma and the safety in uterine fibroids of trauma. Methods A total of 126 patients with uterine fibroids of trauma were selected and divided into two groups. The control group of 63 cases were treated with traditional open surgery, and 63 cases in the treatment group received laparoscopic myomectomy. Postoperative recovery, pain, adverse reactions and postoperative changes in tumor volume were observed. Results After treat- ment, patients were generally in good condition. Postoperative hospital stay was （3.4 ± 1.6） d, get out of bed time was （ 1.3 ±0. 6 ） h and vaginal bleeding time was （3.1 ±0. 9） d in the treatment group, were sig- nificantly shorter than that in the control group [ （ 7. 3± 1.7 ） d, （46. 8± 11.2） h and （ 11.7 ±5.3 ） d, respectively ], and the differences had statistically significant （ P 〈 0.05 ） ; Pain scores of postoperative 6 h and 24 h in the treatment group were significantly better than that in the control group, with significant difference （ P 〈 0. 05 ）, while pain scores of postoperative 72 h was no significant difference （ P 〉 0. 05 ） ; Adverse reaction incidence of postoperative in the treatment group was 23.8% , significantly less than that in the control group （49. 2% ）, with significant difference （P 〈 0. 05）; Postoperative follow-up six months, tumor volume was significantly reduced in the treatment group, hut some patients in the control group still found the growth of the tumor. Conclusions Though laparoscopic myomectomy of uterine fibroid tumor is not resected the tumor completely, but has changed the size of the tumor. The patients recover faster, have less invasive. It is worthy of further promotion.