腹腔镜与宫腔镜手术剔除子宫壁间肌瘤的价值对比

Value comparison of laparoscopic and hysteroscopic myomectomy in the removal of uterine fibroids

目的:研究分析宫腔镜与腹腔镜剔除术对子宫壁间肌瘤的临床治疗效果。方法:选择2014年5月至2016年5月间在本院就诊的244例需进行剔除子宫壁间肌瘤的患者作为研究对象,根据采取的手术方法不同将所有患者分为腹腔镜组及宫腔镜组进行治疗。对患者术中、术后情况进行观察和统计,并对患者进行随访,评价患者术后并发症及妊娠情况。结果:宫腔镜组患者手术时间、住院时间、首次下床活动时间、术后肛门排气时间、术中出血量、手术前后血红蛋白降低程度、术后镇痛、术后1个月、3个月、6个月肌层愈合率、妊娠丢失情况与腹腔镜组患者相比较差异均显著(P<0.05),术后发热、术后月经改善、复发、术后切口脂肪液化、切口硬结红肿反应、季肋部胀痛、中转开腹的情况、术后12个月患者肌层愈合率、术后妊娠率、足月剖宫产情况、因肌瘤剔除术史行剖宫产与腹腔镜组患者相比较差异均不显著(P>0.05)。结论:宫腔镜剔除术治疗子宫壁间肌瘤较腹腔镜剔除术具有更良好的治疗效果。

Objective： To analyze the clinical effect of hysteroscopic and laparoscopic excision of uterine fibroids. Methods： 244 patients to remove uterine fibroids in our hospital from May 2014 to May 2016 were selected and,according to the different surgical methods,were divided into laparoscopic group and hysteroscopic group. The intraoperative and postoperative conditions of patients were observed and patients were followed up to evaluate the postoperative complications and incidence of pregnancy. Results： Differences in the time of operation,hospitalization time,time of off-bed,time of postoperative anal exhaust,intraoperative blood loss,hemoglobin reduction before and after operation,postoperative analgesia,and muscular healing conditions at a month,3 months and 6 months after operation,and incidence of pregnancy were statistically significant between the two groups（ P〈0. 05）,while differences in postoperative fever,postoperative menstrual improvement,recurrence,incisional fat liquefaction,incision scleroderma,swelling of the wound,swelling pain at hypochondrium,incidence of conversion to laparotomy,muscular healing conditions at 12 months after operation,postoperative pregnancy rate,term cesarean section and the ration of patients underwent cesarean section due to the history of myoma excision were not significant（ P〉0. 05）. Conclusions： Hysteroscopic myomectomy has a better therapeutic effect than laparoscopic myomectomy in the removal of uterine fibroids.