腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤疗效观察

THE EFFECT OF LAVH TREATMENT OF GIANT UTERINE FIBROIDS ON THE RECOVERY SPEED AND COMPLICATION RATE OF PATIENTS

目的研究腹腔镜辅助阴式全子宫切除术(LAVH)治疗巨大子宫肌瘤(HLU)对术后恢复及并发症的影响。方法回顾性分析100例德阳市人民医院2015年2月—2018年6月收治并确诊的巨大子宫肌瘤患者的临床资料。根据手术方案进行分组,其中对照组使用传统开腹子宫切除术(TAH)50例,观察组使用腹腔镜辅助阴式全子宫切除术(LAVH)50例,比较二组手术情况,对患者恢复速度、术后并发症情况、疼痛情况及激素水平进行比较。结果观察组的肛门排气时间(0.71±0.19)d、下床活动时间(1.12±0.51)d、住院时间(5.01±0.52)d均短于对照组,并发症发生率(6%)、住院费用(7586.32±1145.22)元均低于对照组(均P<0.05),视觉模拟(VAS)评分(2.06±0.52)分、文字描述(VDS)评分(2.98±1.25)分均低于对照组,但手术时间(112.69±1.12)min长于对照组,差异均有统计学意义(均P<0.05)。二组在术中出血量方面比较,差异无统计学意义(P>0.05)。术前二组雌激素受体(ER)、孕激素受体(PR)水平比较,差异无统计学意义(P>0.05),术后观察组ER、PR水平低于对照组,差异均有统计学意义(均P<0.05)。结论LAVH术治疗巨大子宫肌瘤后患者恢复速度快,并发症发生率低,值得临床应用推广。

Objective To study the effect of laparoscopic assisted vaginal hysterectomy(LAVH)on postoperative recovery and complications in the treatment of giant uterine leiomyoma(HLU)after operation.Methods From February 2015 to June 2018,one hundred patients with giant uterine leiomyoma diagnosed and met the subjects.According to the operation plan,50 cases were divided into two groups,the control group(50 cases)received traditional open hysterectomy(TAH),and the observation group(50 cases)received laparoscopic assisted vaginal hysterectomy(LAVH).Postoperative complications,pain and hormone levels were compared.Results The time of anal exhaust(0.71±0.19)d、out of bed(1.12±0.51)d、hospitalization(5.01±0.52)in the observation group were shorter than those in the control group,the incidence of complications(6%),hospitalization expenses(7586.32±1145.22)were lower than those in the control group(P<0.05),the visual analog visual analogue score,VAS score was(2.06±0.52),and the text description text description scoring method,VDS score was(2.98±1.25),which was lower than that in the control group.The difference between the observation group and the control group was significantly higher than that in the control group(P<0.05).There was no significant difference in ER,PR levels between the two groups before operation(P>0.05).After operation,the level of ER,PR in the observation group was lower than that in the control group,and the results were statistically significant(P<0.05).Conclusion The LAVH operation is rapid and the complication rate is low when it meets the condition of indication.It should be the first choice and the effect is significant.