腹腔镜下全子宫切除术治疗中老年子宫肌瘤的临床效果

Clinical effect of laparoscopic hysterectomy in the treatment of middle-aged and elderly patients with uterine fibroids

目的探讨腹腔镜下全子宫切除术治疗中老年子宫肌瘤的临床效果。方法选取2017年8月~2019年8月江苏省常州市金坛区中医医院收治的100例子宫肌瘤患者作为研究对象,采用随机数字表法分为腹腔镜组(50例)和开腹组(50例),腹腔镜组患者给予腹腔镜下全子宫切除术,开腹组患者给予经腹全子宫切除术。比较两组患者的术中、术后指标及术后并发症的总发生率,并测定术前及术后补体C3和IgG的水平。结果腹腔镜组患者的术中出血量少于开腹组,手术时间、住院时间及肛门排气时间短于开腹组,差异有统计学意义(P<0.05);两组患者术前的C3和IgG水平比较,差异无统计学意义(P>0.05);两组患者术后的C3和IgG水平均低于术前,差异有统计学意义(P<0.05);术后,腹腔镜组患者的C3和IgG水平高于开腹组,差异有统计学意义(P<0.05);腹腔镜组患者术后并发症的总发生率低于开腹组,差异有统计学意义(P<0.05)。结论腹腔镜下全子宫切除术治疗中老年子宫肌瘤患者的临床效果较好,术中出血少,术后恢复快,安全性高。

Objective To explore the clinical effect of the laparoscope in the treatment of the middle-aged and elderly patients with uterine fibroids.Methods From August 2017 to August 2019,100 uterine fibroids patients in Changzhou Jintan District Hospital of Traditional Chinese Medicine were collected as research objects,the patients were divided into laparoscopic group(50 cases)and laparotomy group(50 cases)by random number table method,patients in the laparoscopic group were treated with laparoscopic hysterectomy,while those in the laparotomy group were treated with transabdominal hysterectomy.The clinical therapeutic effect,intraoperative,postoperative indicators and the total incidence of postoperative complications of the two groups were compared,and the serum levels of C3 and IgG before and after surgery were tested.Results The intraoperative blood loss of the laparoscopic group was less than that of the laparotomy group,the operation time,hospital stay and anal exhaust time were shorter than those of the laparotomy group,with statistically significant differences(P<0.05).Before operation,compared with the levels of the C3 and IgG,the differences were not statistically significant(P>0.05).The levels of C3 and IgG after operation were lower than those before operation,the differences were statistically significant(P<0.05).After operation,the levels of the C3 and IgG of the laparoscopic group were than those of the laparotomy group,the differences were statistically significant(P<0.05).The total incidence of postoperative complication of the laparoscopic group was lower than that of the laparotomy group,the difference was statistically significant(P<0.05).Conclusion Laparoscopically hysterectomy for the treatment of middle-aged and elderly patients with uterine fibroids has a good clinical effect,less intraoperative bleeding and faster postoperative recovery and high safety.