经阴道与经腹腔镜手术切除子宫肌瘤的临床疗效对比

Clinical effect of transvaginal and laparoscopic myomectomy

目的探讨经阴道手术及腹腔镜手术切除子宫肌瘤的临床效果。方法选取2018年12月至2020年3月大连大学附属新华医院和大连市妇女儿童医疗中心收治的行子宫肌瘤切除手术的患者40例作为研究对象,按照随机数字表法分为观察组(20例)与对照组(20例),观察组进行经阴道子宫肌瘤切除术,对照组进行经腹腔镜下子宫肌瘤切除术,比较两组患者手术时间、术中出血量,术后胃肠功能恢复时间、术后24 h引流量、术后12 h疼痛评分、住院费用等。结果两组手术均按计划顺利完成,无中转开腹,无肠管、膀胱、输尿管损伤等严重并发症。观察组手术时间短于对照组[(69.75±19.43)min比(84.50±22.4)min],术中出血量少于对照组[(119.25±56.37)ml比(159.00±63.73)ml],差异有统计学意义(P<0.05)。观察组术后胃肠功能恢复时间、术后24 h引流量、术后12 h疼痛评分与对照组比较差异无统计学意义(P>0.05)。观察组住院费用低于对照组[(2.27±0.12)万元比(2.66±0.10)万元],差异有统计学意义(P<0.05)。结论与腹腔镜子宫肌瘤切除术比较,经阴道子宫肌瘤切除手术具有手术时间短、术中出血量少、住院费用低的优势。

Objective To explore the clinical effect of transvaginal and laparoscopic myomectomy.Methods A total of 40 cases treated with hysteromyomectomy in Xinhua Hospital Affiliated to Dalian University and Dalian Women′s and Children′s Medical Center from Decedmber 2018 to March 2020 were selected as the research objects.According to the random number table method,they were assigned into the observation group(20 cases)and the control group(20 cases).In the observation group,hysteromyomectomy was performed via vagina,and in the control group,hysteromyomectomy was performed via laparoscope.Then the time of operation,the amount of bleeding,the recovery time of gastrointestinal function,24 h postoperative drainage,12 h postoperative pain and hospitalization expenses were compared between the two groups.Results The operation of the observation group and the control group were completed as planned.The operation time,the amount of bleeding of the observation groupwere less than those of the control group:(69.75±19.43)min vs.(84.50±22.4)min,(119.25±56.37)ml vs.(159.00±63.73)ml,the differences were statistically significant(P<0.05).The recovery time of gastrointestinal function,24 h postoperative drainage,12 h postoperative pain in two groups had no significant differences(P>0.05).The hospitalization expenses in observation group was lower than that in control group:(2.27±0.12)ten thousand Yuan vs.(2.66±0.10)ten thousand Yuan,the difference was statistically significant(P<0.05).Conclusions Compared with laparoscopic myomectomy,transvaginal myomectomy has the advantages of shorter operation time,less bleeding and less hospitalization expenses.