腹腔镜与开腹手术子宫肌瘤剔除的临床分析

Clinical Analysis of Laparoscopic and Open Surgery for Uterine Fibroids Removal

目的通过对子宫肌瘤患者实施不同的手术方案,观察临床效果,探究不同手术方案的临床特点。方法从来该院诊治的2017年1月—2018年12月的子宫肌瘤患者中随机抽取82例,按照入院先后顺序分为对照组41例:实施传统开腹子宫肌瘤剔除术治疗,观察组41例:实施腹腔镜子宫肌瘤剔除术,比较两组的手术时间、手术出血量、住院天数、下床活动时间、胃肠功能恢复时间,并发症及术后预后情况。结果观察组手术时间、手术出血量、住院天数、下床活动时间、胃肠功能恢复时间低于对照组(P<0.05);观察组复发率为7.32%低于对照组(21.95%)(χ^2=11.352,P<0.05),肌瘤残留率为4.88%低于对照组(19.51%)(χ^2=13.753,P<0.05);观察组尿潴留发生率为7.32%低于对照组(χ^2=10.053,P<0.05),疼痛率为17.07%低于对照组(χ^2=11.527,P<0.05),感染率为4.88%低于对照组(χ^2=12.683,P<0.05),肠粘连率为2.44%低于对照组(χ^2=9.590,P<0.05)。结论腹腔镜子宫肌瘤剔除术可以有效降低子宫肌瘤患者的手术时间、手术出血量、住院天数、下床活动时间、胃肠功能恢复时间,改善术后并发症和预后,是一项值得临床广泛应用的手术方案。

Objective To observe the clinical effects of different surgical procedures by implementing different surgical plans for patients with uterine fibroids. Methods 82 patients with uterine fibroids from January 2017 to February 2018 in our hospital were randomly selected and divided into the control group according to the order of admission;41 cases were treated with traditional open uterine myomectomy, and observation group of 41 patients underwent laparoscopic myomectomy. The operation time, the amount of surgical bleeding, the length of hospital stay, the time of getting out of bed, the recovery time of gastrointestinal function, complications and postoperative prognosis were compared between the two groups. Results The operation time, surgical bleeding volume, hospitalization days, time of getting out of bed, and recovery time of gastrointestinal function in the observation group were lower than those in the control group (P<0.05). The recurrence rate of the observation group was 7.32% lower than that of the control group (21.95%)(χ^2=11.352, P<0.05), the residual rate of fibroids was 4.88% lower than that of the control group (19.51%)(χ^2=13.753, P<0.05);the incidence of urinary retention in the observation group was 7.32% lower than that of the control group (χ^2=10.053, P<0.05), the pain rate was 17.07% lower than the control group (χ^2=11.527, P<0.05), the infection rate was 4.88% lower than the control group (χ^2=12.683, P<0.05), and the intestinal adhesion rate was 2.44%, lower than the control group (χ^2=9.590, P<0.05). Conclusion Laparoscopic uterine fibroids removal can effectively reduce the operation time, surgical bleeding volume, length of hospital stay, time to get out of bed, recovery time of gastrointestinal function, and improve postoperative complications and prognosis, which can be one of the widely used surgical solutions.