腹腔镜与开腹全子宫切除术治疗中年子宫肌瘤患者的疗效比较

Comparison of the Curative Effect of Laparoscopic and Open Total Hysterectomy on Middle-aged Patients with Uterine Fibroids

目的比较腹腔镜与开腹全子宫切除术治疗中年子宫肌瘤患者的疗效。方法选取舞阳县人民医院2018年7月至2020年7月接收的中年子宫肌瘤患者86例,依据治疗方案分为两组,每组43例。开腹组行开腹子宫切除术,腹腔镜组行腹腔镜全子宫切除术,统计对比两组手术时间、术中失血量、排气时间、下床活动时间、住院时间、并发症状况、术前、术后1 d、3 d创伤应激[去甲肾上腺素(NE)、皮质醇(Cor)]以及术前、术后6 h、12 h、24 h疼痛数字评价量表(NRS)评分。结果腹腔镜组手术时间、住院时间、排气时间、下床活动时间短于开腹组、术中失血量少于开腹组,差异有统计学意义(P<0.05);术后6 h、12 h、24 h腹腔镜组NRS评分低于开腹组,差异有统计学意义(P<0.05);术后1 d、3 d腹腔镜组血清NE、Cor水平低于开腹组,差异有统计学意义(P<0.05);与开腹组23.26%(10/43)对比,腹腔镜组并发症发生率4.65%(2/43)明显减少,差异有统计学意义(P<0.05)。结论腹腔镜全子宫切除术治疗中年子宫肌瘤患者,能优化手术进程,减轻创伤,有助于促进术后恢复,缓解患者疼痛,提高手术安全性。

Objective To compare the efficacy of laparoscopic and open total hysterectomy in the treatment of middle-aged patients with uterine fibroids.Methods A total of 86 middle-aged patients with uterine fibroids admitted to Wuyang County People's Hospital from July 2018 to July 2020 were selected and divided into two groups according to the treatment plan,with 43 cases in each group.The open group received open hysterectomy,the laparoscopic group received laparoscopic total hysterectomy,Operation time,intraoperative blood loss,exhaust time,time to get out of bed,length of hospital stay,complications,preoperative,postoperative 1 d,3 d traumatic stress[norepinephrine(NE),cortisol(Cor)]and preoperative,postoperative 6 h,12 h,24 h pain digital Evaluation Scale(NRS)scores were statistically compared between the two groups.Results The operative time,hospital stay,exhaust time and ambulation time of the laparoscopic group were shorter than those of the open group,and the intraoperative blood loss was less than that of the open group,the differences were statistically significant(P<0.05).The NRS score of laparoscopic group was lower than that of open group at 6 h,12 h and 24 h postoperatively,the difference was statistically significant(P<0.05).The levels of serum NE and Cor in laparoscopic group were lower than those in open group on day 1 and day 3 after operation,the differences were statistically significant(P<0.05).Compared with the open group(23.26%,10/43),the complication rate of the laparoscopic group(4.65%,2/43)was significantly reduced,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic total hysterectomy for middle-aged patients with uterine fibroids can optimize the surgical process,reduce trauma,help promote postoperative recovery,relieve patients'pain,and improve the safety of surgery.