腹腔镜子宫肌瘤剔除术与传统开腹子宫肌瘤剔除术治疗巨大子宫肌瘤的效果及安全性比较

Comparison of the effects and safety of laparoscopic myomectomy and traditional open myomectomy in the treatment of giant uterine fibroids

目的 比较腹腔镜子宫肌瘤剔除术与传统开腹子宫肌瘤剔除术治疗巨大子宫肌瘤的效果及安全性。方法 选取2019年5月至2021年1月在我院行手术治疗的90例巨大子宫肌瘤患者,采用随机数字表法将其分为对照组(45例,传统开腹子宫肌瘤剔除术)和研究组(45例,腹腔镜子宫肌瘤剔除术)。比较两组的治疗效果。结果 研究组的手术时间显著长于对照组,住院时间及术后首次排气时间显著短于对照组,术中出血量显著少于对照组(P<0.05)。术后1个月,研究组的黄体生成素(LH)、卵泡刺激素(FSH)水平低于对照组,雌二醇(E_(2))水平高于对照组(P<0.05)。术后7 d,研究组的P物质(SP)、肿瘤坏死因子-α(TNF-α)水平均低于对照组(P<0.05)。研究组的并发症总发生率显著低于对照组(P<0.05)。结论 采用腹腔镜子宫肌瘤剔除术治疗巨大子宫肌瘤,可减少术中出血量,缩短住院时间及术后首次排气时间,减轻卵巢功能损伤和应激反应,安全性高。

Objective To compare the effects and safety of laparoscopic myomectomy and traditional open myomectomy in the treatment of giant uterine fibroids.Methods Ninety patients with giant uterine fibroids who underwent surgical treatment in our hospital from May 2019 to January 2021 were selected and divided into control group(45 cases,traditional open hysteromyomectomy)and study group(45 cases,laparoscopic hysteromyomectomy)according to the random number table method.The therapeutic effects of the two groups were compared.Results The operation time in the study group was significantly longer than that in the control group,the hospital stay time and the first exsufflation time after operation were significantly shorter than those in the control group,and the intraoperative blood loss was significantly less than that in the control group(P<0.05).One month after operation,the levels of luteinizing hormone(LH)and follicle-stimulating hormone(FSH)in the study group were lower than those in the control group,and the level of estradiol(E_(2))was higher than that in the control group(P<0.05).At 7 d after operation,the levels of substance P(SP)and tumor necrosis factor-α(TNF-α)in the study group were lower than those in the control group(P<0.05).The total incidence of complications in the study group was significantly lower than that in the control group(P<0.05).Conclusion Laparoscopic myomectomy in the treatment of giant uterine fibroids can reduce the intraoperative blood loss,shorten the hospital stay and the first exsufflation time after operation,and reduce ovarian function damage and stress response,with high safety.