腹腔镜和开腹子宫肌瘤剔除术的临床效果比较及并发症发生情况分析

Clinical analysis of laparoscopic and open uterine myomectomy and analysis of complications

目的分析腹腔镜和开腹子宫肌瘤剔除术的临床疗效及安全性。方法将2012年4月至2016年4月期间经单县妇幼保健院确诊的160例子宫肌瘤患者选作研究病例，按照就诊顺序编号并将单双号分作两组。对照组为单号80例患者采用开腹子宫肌瘤剔除术，观察组为双号80例患者行腹腔镜子宫肌瘤剔除术，分析临床治疗效果以及并发症的发生情况。结果观察组手术时间（78．46±10．31）min、术中出血量（86．24±7．65）mL、切口大小（25．36±1．28）mm，均明显少于对照组，差异均有统计学意义（t=6．57、6．81、7．66，均P〈0．05）。观察组术后体温恢复时间（24．16±3．81）h、肛门排气时间（18．29±4．36）h、下床活动时间（11．38±2．06）h、住院时间（4．63±1．51）d均较对照组明显缩短，差异均有统计学意义（t=6．25、7．38、7．70、6．27，均P〈0．05）。观察组术后病率（6．25％）和术后镇痛率（11．25％）均较对照组明显降低，差异均有统计学意义（χ2=8．33、9．07，均P〈0．05）。观察组术后并发症发生率为6．25％，较对照组的25．00％明显降低，差异有统计学意义（χ2=8．65，P〈0．05）。结论与开腹子宫肌瘤剔除术相比，腹腔镜子宫肌瘤剔除术具有创伤小、出血少、恢复快、并发症少等优势，且安全性高，是临床治疗子宫肌瘤的理想术式，值得进行推广和应用。

Objective TO analyze the clinic/d efficacy and safety of laparoacopic and open uterine myomectomy. Methods 160 cases of uterine fibroids diagnosed by our hospital from April 2012 to April 2016 were selected as study cases. The patients were divided into two groups according to the order of treatment. 80 patients in the control group received open uterine myoma rejection. 80 patients in the observation group received laparoscopic myomectomy. The clinical treatment effect and complication were analyzed. Results The operation time, amount of intraoperative blood loss and the incision size of the observation group were （78.46 ± 10.31 ） min, （ 86.24 ± 7.65 ） mL, （ 25.36 ± 1.28 ） mm, respectively, which were significantly less than those in the control group, the differences were statistically significant （t =6.57,6.81,7.66,all P 〈0.05）. The time of postoperative body temperature recovery, time of anal exhanst,time of bedtime and the hospitalization time of the observation group were （24. 16 ± 3.81 ） h, （ 18.29 ± 4. 36） h, （ 11.38 ± 2.06 ） h, （4.63 ± 1.51 ） d, respectively, which were significantly shorter than those in the control group （ t = 6.25,7.38,7.70,6.27, all P 〈 0. 05 ）. The operative rate and postoperative analgesia rate of the observation group were 6.25% and 11.25%, respectively, which were significantly lower than those of the control group （χ2 = 8.33,9.07 ,all P 〈 0.05 ）. The incidence rate of postoperative complications was 6.25% in the observation group, which was significantly lower than 25.00% in the control group, the difference was statistically significant （ χ2 = 8.65,P 〈 0.05 ）. Conclusion Laparoscopic myomectomy has the advantages of less trauma, less bleeding, quick recovery and less complication, and high safety. It is the ideal technique for the treatment of uterine fibroids, which is worthy of promotion and application.