腹腔镜手术和经腹手术方式对子宫肌瘤患者术后妊娠的影响

Study on the effect of laparoscopic operation and abdominal operation on the outcome of pregnant patients with uterine myoma

目的 探讨腹腔镜手术和经腹手术方式对子宫肌瘤患者术后妊娠的影响,为有生育需求的患者在选择手术方式时提供科学依据。方法 选取于2011年1月至2012年3月收治的132例子宫肌瘤患者为研究对象,按照手术方式将患者分为腹腔镜手术组（65例）和经腹手术组（67例）,比较两组患者子宫肌瘤种类、子宫肌瘤所在部位、子宫肌瘤大小、子宫肌瘤个数、术后妊娠率、生产方式、生产过程、新生儿质量等。结果 经过为期3年的观察期,腹腔镜手术组术后有55例患者怀孕,成功妊娠47例,怀孕率72.30%;经腹手术组术后有56例患者怀孕,成功妊娠49例,怀孕率71.34%,两组比较差异无统计学意义（χ~2=0.01,P〉0.05）;腹腔镜手术组和经腹手术组患者在顺产、剖宫产、胎吸助产、产钳助产等情况比较差异无统计学意义（P〉0.05）;在分娩时间、生产过程中出血量、需要输血的病例等情况比较差异无统计学意义（P〉0.05）;两组患者所产新生儿的Apgar评分（1 min、5 min）和NACS评分（15 min、24 h）结果显示两组患者所产新生儿质量比较差异无统计学意义（P〉0.05）。结论 对于有生育需求的子宫肌瘤患者,无论是采用腹腔镜还是经腹手术治疗的手术方式,治疗效果无显著差异,均安全可靠。

Objective To explore the effect of laparoscopic operation and abdominal operation on the outcome of pregnant patients with u- terine fibroids, and to provide scientific basis for the choice of operational mode, Methods A total of 132 cases of uterine fibreids during March January 2011 to JAnuary 2012 were selected for this study, they were divided into laparoseopic surgery group （65 cases） and abdominal operation group （67 eases） according to their operational mode and the kinds of uterine fibreids, location of fbroids, size and number of uterine fibreids, rate of postoperative pregnancy, mode of labour, process of labour, neonatal quality, ete were compared. Results After an observation period of 3 years, successful pregnancy had been seen in 55 patients of lapaoscopic surgery group with successful pregnancy in 47 eases, and the pregnancy rate was 72.30%. 56 patients in abdominal surgery group had pregnancy after operation, and the successful pregnancy had been seen in 49 cases, with the pregnancy rate of 71.34%, but the difference between these two groups was not statistically significant （ x^2 = 0.01, P 〉 0.05 ）. The difference in complete birth, cesarean section, fetal sucking midwifery, forceps delivery etc. between these 2 groups was not statistically significant （ P 〉 0.05 ）. There was no significant difference in the time of delivery and the amount of blood loss during the process of production and the need for blood transfusion （ P 〉0.05）. The results in neonatal Apgar scores （1 rain, 5 min） and NACS scores （15 min, 24 h） showed no significant difference between these two groups of patients with neonatal quality （ P 〉 0.05 ）. Conclusion For patients with uterine fibroids having fertility requirement, whether the operation is lapamscopic or abdominal surgery, the effect of treatment is not significantly different, and they are safe and reliable.