腹腔镜下复杂性子宫肌瘤剥除术的应用价值

Application value of laparoscopic complicated uterine fibroids removal

目的探讨腹腔镜下复杂性子宫肌瘤剥除术的可行性、安全性和手术技巧,为临床治疗提供参考。方法选取2016年1月至2019年1月如皋磨头医院收治的58例子宫肌瘤患者,按照随机数字表法分为观察组和对照组,每组29例。观察组采取腹腔镜手术剥除子宫肌瘤,对照组采取开腹手术剥除子宫肌瘤。对比A、B两组患者的术中出血量、手术时长、住院时长和术后肛门排气时间、术后止痛药使用情况,对比术后并发症发生情况。结果观察组患者手术时长短于对照组,术中出血量明显低于对照组,差异有统计学意义(P <0.05)。观察组患者术后使用止痛药比例明显低于对照组,住院时长和术后肛门排气时间均短于对照组,差异均有统计学意义(P <0.05)。观察组并发症总发生率为13.79%,明显低于对照组的37.93%,差异有统计学意义(P <0.05)。结论腹腔镜下行复杂子宫肌瘤剥除对于熟练掌握一定手术技巧的高年资术者是安全可行的,对患者损伤小、术后恢复快。

Objective To investigate the feasibility, safety and surgical skills of laparoscopic complicated uterine fibroids removal, and to provide reference for clinical treatment. Methods From January 2016 to January 2019, 58 patients with uterine fibroids admitted to the Datoutou Hospital were randomly divided into observation group and control group, with 29 cases in each group. The observation group was treated with laparoscopic surgery to remove uterine fibroids, and the control group was treated with open surgery to remove uterine fibroids. The intraoperative blood loss, length of surgery, length of hospital stay, postoperative anal exhaust time, postoperative analgesic use, and postoperative complications were compared between the two groups. Results The length of operation in the observation group was shorter than that in the control group. The intraoperative blood loss was significantly lower than that in the control group, and the difference was statistically significant(P < 0.05). The proportion of postoperative analgesics in the observation group was significantly lower than that in the control group. The length of hospital stay and postoperative anal exhaust time were shorter than the control group, and the difference was statistically significant(P < 0.05). The total incidence of complications in the observation group was 13.79%, which was significantly lower than that in the control group(37.93%). The difference was statistically significant(P < 0.05). Conclusion Laparoscopic uterine fibroids removal is safe and feasible for high-level surgeons who are skilled in certain surgical techniques. It has less damage to patients and quick recovery after surgery.