96例经腹腔镜与经阴式子宫肌瘤剔除术的临床疗效

96 cases of laparoscopic and vaginal hysterectomy

目的探讨在妇科子宫肌瘤患者中运用经腹腔镜或经阴式子宫肌瘤剔除术的临床作用。方法通过随机对照试验的方式将我院妇科近三年治疗的96例子宫肌瘤患者进行分组，A组48例选择经腹腔镜子宫肌瘤剔除术（LM）治疗，B组48例选择经阴式子宫肌瘤剔除术（VM）治疗，针对两组的临床手术情况作比较和评估。结果在术中指标上，两组的肌瘤剔除数目比较相当，差异无统计学意义（P〉0．05），但A组的手术用时相比B组明显缩短，术中出血量明显减少，差异有统计学意义（P〈0．05）；在术后指标上，相对B组而言，A组的术后排气功能恢复更快，下地活动时间与住院时间更短，但医疗费用更高，差异有统计学意义（P〈0．05）。在术后3、6个月的复查中，发现两组的术后残留率与复发率基本相近，差异无统计学意义（P〉0．05）。结论选择LM手术方案对子宫肌瘤患者进行治疗，总体效果要比VM手术更加理想，但易加重患者医疗负担，治疗时需视其情况合理选择。

Objective To investigate the clinical effect of laparoscopic versus transvaginal hysterectomy in the treatment of patients with gynecologic uterine fibroids. Methods 96 patients with uterine fibroids treated at our hospital these three years were divided into group A and group B according to randomized controlled trials, 48 for each group. Group A were treated with laparoscopic myomectomy （LM） and group B vaginal myomectomy. The surgical state in both groups were compared and evaluated. Results There was no statistical difference in myomas number between these two groups （P 〉 0.05）. The operation time was obviously shorter, the intra-opcrative bleeding volume was much lower in group A than in group B, with statistical differences （P 〈 0.05）. After the operation, the exhaust function recovered faster, the time for activity off bed and hospital stay were shorter, but the medical cost was higher in the group A than in group B, with statistical differences （P 〈 0.05）. 3 and 6 months after the operation, there were no statistical differences in residual rate and recurrence rate between these two groups （P 〉 0.05）. Conclusions LM for patients with uterine fibroids is more effective than VM, but would heaven the patients＇ medical burden.