腹腔镜与经腹子宫肌瘤剔除术的临床对照分析

Clinical comparative analysis of laparoscopic and transabdominal myomectomy

目的探讨腹腔镜子宫肌瘤剔除术和经腹子宫肌瘤剔除术的临床效果。方法 150例子宫肌瘤患者,按随机抽签法分为研究组与对照组,各75例。对照组采取经腹子宫肌瘤剔除术治疗,研究组采取腹腔镜子宫肌瘤剔除术治疗。对比两组患者手术指标、术后并发症发生情况、术后子宫肌瘤残留率、术后3 d血清创伤反应指标。结果研究组术中出血量(77.9±17.5)ml少于对照组的(104.6±16.9)ml,手术时间(122.5±25.6)min长于对照组的(111.6±21.9)min,术后住院时间(6.4±1.2)d短于对照组的(8.4±1.6)d,差异均有统计学意义(P<0.05)。研究组并发症发生率6.7%低于对照组的17.3%,差异有统计学意义(P<0.05)。研究组患者术后子宫肌瘤残留率为10.7%,高于对照组的1.3%,差异有统计学意义(P<0.05)。研究组术后3 d的缺血修饰蛋白、肌红蛋白、总抗氧化能力分别为(67.5±5.1)U/L、(25.4±1.3)ng/ml、(10.6±0.5)kU/L,均优于对照组的(73.7±4.3)U/L、(28.0±2.3)ng/ml、(8.3±0.4)kU/L,差异有统计学意义(t=8.049、8.523、31.108, P<0.05)。结论腹腔镜子宫肌瘤剔除术的微创优势突出。

Objective To discuss the clinical effect of laparoscopic and transabdominal myomectomy.Methods A total of 150 patients with hysteromyoma were divided into research group and control group according to lottery method,with 75 cases in each group.The control group was treated with transabdominal myomectomy,and the research group was treated with laparoscopic myomectomy.The operative indicators,occurrence of postoperative complications,residual fibroids rate,and serum trauma response indexes of the two groups were compared and analyzed.Results The intraoperative blood loss(77.9±17.5)ml of the research group was less than(104.6±16.9)ml of the control group,operation time(122.5±25.6)min was longer than(111.6±21.9)min of the control group,and postoperative hospitalization time(6.4±1.2)d was shorter than(8.4±1.6)d of the control group,and the difference was statistically significant(P<0.05).The incidence of complications 6.7%of the research group was lower than 17.3%of the control group,and the difference was statistically significant(P<0.05).The residual fibroids rate of the research group was 10.7%,which was higher than 1.3%of the control group,and the difference was statistically significant(P<0.05).The ischemia-modifying protein,myoglobin and total antioxidant capacity of the research group 3 d after operation were(67.5±5.1)U/L,(25.4±1.3)ng/ml,(10.6±0.5)kU/L,respectively,which were all better than(73.7±4.3)U/L,(28.0±2.3)ng/ml and(8.3±0.4)kU/L of the control group,and the difference was statistically significant(t=8.049,8.523,31.108,P<0.05).Conclusion The minimally invasive advantages of laparoscopic myomectomy are outstanding.