腹腔镜下子宫肌瘤剔除术治疗子宫肌瘤71例

Laparoscopic myomectomy for uterine fibroids: a report of 71 cases

目的探讨子宫肌瘤患者行腹腔镜下子宫肌瘤剔除术的手术技巧与疗效。方法回顾性分析2014年1月至2016年1月要求保留子宫行腹腔镜子宫肌瘤切除术的子宫肌瘤患者71例(腹腔镜组)和同期61例行开腹子宫肌瘤剔除术患者(开腹组)的资料,比较两组患者术中出血量、手术时间、术后住院时间、术后排气时间、切口甲级愈合率及随访结果。结果腹腔镜组单发性肌瘤54例,多发肌瘤17例,其中多发肌瘤最多者有6枚肌瘤,单发肌瘤直径5. 0～9. 0 cm。腹腔镜组较开腹组术中出血量少,术后住院时间、术后排气时间缩短,手术时间长(P <0. 01),切口甲级愈合率无统计学差异(P> 0. 05)。患者随访率为100%,随访3～6个月,术后3个月复查B超提示子宫切口处均愈合良好。结论腹腔镜子宫肌瘤切除术治疗子宫肌瘤出血量少、住院时间短,安全可靠。

Objective To investigate the surgical technique and efficacy of laparoscopic myomectomy in patients with uterine fibroids. Methods A retrospective analysis was made in 71 patients（laparoscopic group） and 61 patients（laparotomy group） who required hysteromyomectomy from January 2014 to January 2016. The operative bleeding volume,operative time,postoperative hospital stay,postoperative exhaust time,class-A healing rate of surgical incision and follow-up results were compared between two groups. Results In the laparoscopic group,single myoma occurred in 54 patients,and multiple myoma occurred in 17 patients with maximum number of 6 uterine fibroids. The diameter of single myoma was 5. 0-9. 0 cm. Compared with laparotomy group,the bleeding volume,postoperative hospital stay and exhaust time decreased,and operative time increased in laparoscopic group（P〈0. 01）. There was no statistical difference in class-A healing rate of surgical incision between two groups（P〉0. 05）. All patients were follow-up for 3 to 6 months with 100% follow-up rate. At3 months after operation,B ultrasound examination suggested a good healing of uterine incision. Conclusion Laparoscopic hysteromyomectomy is safe and reliable with less bleeding and shorter hospitalization.