腹腔镜子宫肌瘤剔除术治疗子宫肌瘤的疗效及对术后妊娠的影响

Efficacy of laparoscopic myomectomy on uterine leiomyoma and its influence on postoperative pregnancy

目的探讨腹腔镜子宫肌瘤剔除术治疗子宫肌瘤的疗效及对术后妊娠的影响。方法 84例子宫肌瘤患者,按照手术方式的不同分成研究组和对照组,各42例。研究组采用腹腔镜子宫肌瘤剔除术进行治疗,对照组采用传统开腹手术进行治疗。观察比较两组术中出血量、手术时间、肛门首次排气时间;比较两组术后肌瘤残余、复发及并发症发生情况;比较两组术后妊娠情况。结果研究组术中出血量(269.93±41.09)ml少于对照组的(318.31±21.47)ml,手术时间(79.93±11.08)min及肛门首次排气时间(13.04±2.18)h均显著短于对照组的(102.23±16.28)min、(21.31±3.47)h,差异有统计学意义(P<0.05)。研究组术后肌瘤残余率和复发率分别为4.76%、14.29%,对照组术后肌瘤残余率和复发率分别为4.76%、11.90%,比较差异无统计学意义(P>0.05)。研究组并发症发生率为4.76%,明显低于对照组的21.43%,差异有统计学意义(P<0.05)。研究组妊娠率68.75%、足月妊娠率81.82%、流产率13.64%与对照组的76.92%、80.00%、15.00%比较差异无统计学意义(P>0.05)。结论腹腔镜子宫肌瘤剔除术治疗子宫肌瘤的疗效较好,且对患者术后妊娠能力的影响较小,值得在临床大力推广。

Objective To discuss the efficacy of laparoscopic myomectomy on uterine leiomyoma and its influence on postoperative pregnancy. Methods A total of 84 uterine leiomyoma patients were divided by different surgical methods into research group and control group, with 42 cases in each group. The research group was treated with laparoscopic myomectomy, and the control group was treated with traditional open surgery. Observation and comparison were made on intraoperative bleeding volume, operation time, first time of anal exhaust, postoperative myoma residual, recurrence and complications, and postoperative pregnancy between the two groups. Results The research group had less intraoperative bleeding volume as (269.93±41.09) ml than (318.31±21.47) ml in the control group, and significantly shorter operation time as (79.93±11.08) min and first time of anal exhaust as (13.04±2.18) h than (102.23±16.28) min and (21.31±3.47) h in the control group. Their difference was statistically significant (P<0.05). The research group had postoperative myoma residual, recurrence rate respectively as 4.76% and 14.29%, which were 4.76% and 11.90% in the control group, and their difference was not statistically significant (P>0.05). The research group had obviously lower incidence of complications as 4.76% than 21.43% in the control group, and the difference was statistically significant (P<0.05). The research group had pregnancy rate as 68.75%, full-term pregnancy rate as 81.82%, and abortion rate as 13.64%, which were 76.92%, 80.00% and 15.00% in the control group. Their difference was not statistically significant (P>0.05). Conclusion Laparoscopic myomectomy shows good efficacy in treating uterine leiomyoma, and it has little influence on postoperative pregnant ability. It is worthy of clinical promotion.