腹腔镜子宫肌瘤剔除术治疗子宫肌瘤的疗效分析

Analysis of the Effect of Laparoscopic Myomectomy in the Treatment of Uterine Myoma

目的探讨腹腔镜子宫肌瘤切除术在治疗子宫肌瘤中的应用疗效。方法在2018年1月—2019年12月选取104例子宫肌瘤患者进行研究,按照随机数表的排序将患者分入对照组、观察组各52例。对照组行传统开腹手术治疗,观察组患者行腹腔镜下子宫肌瘤剔除术治疗,比较不同术式的围术期指标,术后雌激素水平及并发症发生情况。结果观察组术中出血量(120.62±27.62)mL少于对照组的(238.01±29.25)mL,差异有统计学意义(t=21.042,P<0.001),胃肠功能复常时间、住院时间为(26.52±3.52)h、(4.90±2.52)d,短于对照组的(37.28±4.92)h、(7.44±2.91)d,差异有统计学意义(t=12.826、4.758,P<0.001)。术后观察组E2为(246.29±24.31)pmol/L,高于对照组的(220.32±20.15)pmol/L,LH、FSH分别为(17.30±2.34)、(19.69±2.47)U/L,低于对照组的(20.65±3.47)、(23.67±4.36)U/L,差异有统计学意义(t=5.931、5.772、5.727,P<0.001)。观察组手术后并发症总发生率为7.69%,低于对照组的26.92%,差异有统计学意义(χ^(2)=6.718,P=0.010)。结论腹腔镜下子宫肌瘤剔除术治疗效果与传统开腹手术基本相当,但其出血更少,对卵巢功能影响更小,并发症风险更低,有利于患者术后康复。

Objective To explore the effect of laparoscopic myomectomy in the treatment of uterine fibroids.Methods From January 2018 to December 2019,104 patients with uterine fibroids were selected for the study,divided into the control group and the observation group according to the random number table,52 cases in each group.The control group underwent traditional open surgery,and the observation group underwent laparoscopic myomectomy.The perioperative indicators of different surgical methods,postoperative estrogen levels and complications were compared.Results The intraoperative blood loss in the observation group was(120.62±27.62)mL,which was less than that in the control group(238.01±29.25)mL.The difference was statistically significant(t=21.042,P<0.001).The time to normal gastrointestinal function and the length of hospital stay were(26.52±3.52)h,(4.90±2.52)d,shorter than the control group(37.28±4.92)h,(7.44±2.91)d,the difference was statistically significant(t=12.826,4.758,P<0.001).The E_(2) of the observation group after operation was(246.29±24.31)pmol/L,which was higher than that of the control group(220.32±20.15)pmol/L.LH and FSH were(17.30±2.34)U/L and(19.69±2.47)U/L,which was lower than the control group(20.65±3.47)U/L,(23.67±4.36)U/L,the difference was statistically significant(t=5.931,5.772,5.727,P<0.001).The total incidence of postoperative complications in the observation group was 7.69%,which was lower than 26.92%in the control group.The difference was statistically significant(χ^(2)=6.718,P=0.010).Conclusion The therapeutic effect of laparoscopic myomectomy is basically the same as that of traditional laparotomy,but it has less bleeding,less impact on ovarian function,and lower risk of complications,which is conducive to postoperative recovery.