腹腔镜辅助下三种手术方式治疗子宫肌瘤的临床疗效比较

Clinical comparison of three kinds of operation mode under laparoscope in treatment of uterine fibroids

目的 观察腹腔镜辅助下三种手术方式治疗子宫肌瘤的疗效.方法 选取子宫肌瘤患者100例作为研究对象,分别行腹腔镜辅助下阴式子宫肌瘤剔除术（LATM）、阴式子宫切除术（LAVH）、阴式子宫次全切除术（LAVSH）,根据手术类型将患者分为LATM组（35例）、LAVH组（30例）、LAVSH组（35例）,观察三组手术时间、术中出血量、排气时间、住院治疗时间,并记录术后并发症发生率.结果 LATM组手术时间、术中出血量、排气时间以及住院治疗时间分别为（57.26±10.11） min、（60.39±11.68） ml、（1.20±0.43）d、（4.98±1.63）d,均低于LAVH组、LAVSH组,其中LAVH组最高,差异有统计学意义（P＜0.05）.LATM组与LAVSH组并发症发生率分别为2.86％、11.43％,差异未见统计学意义（P＞0.05）,但两组术后并发症发生率均低于LAVH组（33.33％）,差异有统计学意义（P＜0.05）.结论 三种腹腔镜辅助下手术均可用于子宫肌瘤的治疗中,但腹腔镜辅助下LATM手术可减少术中创伤,降低并发症发生率.

Objective To observe the curative effects of three kinds of operation mode under laparoscope on uterine fibroids.Methods One hundred uterine fibroids patients were selected as research objects,underwent laparoscopic assisted vaginal myomectomy （LATM） and vaginal hysterectomy （LAVH）,transvaginal subtotal hysterectomy （LAVSH）,according to the type of surgery,patients were divided into LATM group （35 cases）,LAVH group （30 cases） and LAVSH group （35 cases）.The operative time,bleeding volume,exhaust time,hospitalization time were observed,and the incidence of postoperative complications were recorded.Results In LATM group,the operative time,bleeding amount,exhaust time and hospitalization time were （57.26 ± 10.11） min,（60.39 ± 11.68） ml,（1.20 ±0.43） d,（4.98 ± 1.63） d,which were lower than that in LAVH group,LAVSH group,the LAVH group was the highest,the differences were significant （P 〈 0.05）.The incidence of complications of LATM group and LAVSH group were 2.86% and 11.43%,there was no significant difference （P 〉 0.05）.But the incidence of postoperative complications of two groups was lower than that in LAVH group （33.33%）,the differences were significant （P 〈 0.05）.Conclusions The three laparoscopic assisted surgery can be used as treatment of uterine fibroids,but laparoscopic LATM surgery can reduce the surgical trauma and reduce the incidence of complications.