腹腔镜和开腹手术在子宫肌瘤剔除术中的效果比较

Comparison the effect and complication of laparoscope and open abdominal in uterine fibroids elimination

目的比较腹腔镜和开腹子宫肌瘤剔除术的临床效果,并评价其并发症发生情况。方法选取我院2012年3月~2014年3月收治的100例子宫肌瘤患者,经确认后均需行子宫肌瘤剔除术,按入院时间顺序随机分为两组,观察组50例,采用腹腔镜子宫肌瘤剔除术,对照组50例,采用开腹子宫肌瘤剔除术。所有患者术后均随访2年6个月,记录并分析两组患者的住院时间、手术时间、术中出血量、术后肛门排气时间、术后下床活动时间、术后妊娠率、术后症状缓解率,比较周围脏器损伤、术后肌瘤残余、月经周期紊乱、肌瘤复发等并发症情况及总并发症发生率。结果观察组住院时间为(3.52±2.23)d,手术时间为(57.62±12.34)min,术中出血量为(82.87±28.03)ml,术后肛门排气时间为(18.58±5.01)h,术后下床活动时间为(10.35±2.66)h,均显著低于对照组[(7.03±2.68)d、(78.53±21.42)min、(141.12±31.63)ml、(21.36±6.72)h、(12.88±3.75)h];术后妊娠率(84.0%)明显高于对照组(66.0%),差异均有统计学意义(P<0.05)。观察组总并发症发生率为2.0%,显著低于对照组(14.0%),差异有统计学意义(P<0.05)。结论腹腔镜下子宫肌瘤剔除术具有手术时间短、术中出血少、术后恢复快、并发症少等优点,是一种安全可靠的手术方式。

Objective To compare the clinical effect of laparoscope and open abdominal uterine fibroids elimination,and to evaluate the complications.Methods One hundred patients with uterine fibroid from March 2012 to March 2014 in our hospital were selected and conducted uterine fibroids elimination after confirmation.Patients were divided into two groups according to admission order,50 patients in observation group were treated by the laparoscope uterine fibroids elimination and 50 patients in control group were treated by the open abdominal uterine fibroids elimination.All patients were followed up for 2 years and 6 months.The hospital stay,operation time,bleeding during operation,postoperative anal exhaust time,postoperative bed activity time,pregnancy rate after operation and symptom relief rate after operation in two groups were recorded and analyzed.The complications and incidence rate of total complications of peripheral organ injury,postoperative residual tumour,menstrual cycle disorder and myoma recurrence were compared.Results The hospital stay,operation time,bleeding during operation,postoperative anal exhaust time and postoperative bed activity time in observation group were respectively（3.52 ±2.23）d,（57.62±12.34）min,（82.87 ±28.03）ml,（18.58 ±5.01）h,and（10.35 ±2.66）h,which were obvious lower than those of the control group [（7.03 ±2.68）d,（78.53 ±21.42）min,（141.12 ±31.63）ml,（21.36 ±6.72）h,（12.88±3.75）h];pregnancy rate after operation was 84.0%,was obvious higher than that in control group（66.0%）,and the differences were statistical significance（P〈0.05）.The incidence rate of total complications in observation group was 2.0%,was obvious lower than that in control group（14.0%）,and the difference was statistical significance（P〈0.05）.Conclusion Laparoscope uterine fibroids elimination with the advantages of shorter operation time,less bleeding during operation,fast postoperative recovery and little complications,it is a safety operation.