顺行阴式与腹腔镜下子宫肌瘤剔除术治疗子宫肌瘤的疗效及安全性研究

Efficacy and safety of anterograde vaginal and laparoscopic myomectomy in the treatment of uterine myoma

目的探讨顺行阴式子宫肌瘤剔除术(VM)与腹腔镜下子宫肌瘤剔除术(LM)治疗子宫肌瘤(UM)患者的应用价值。方法选取80例行手术治疗的UM患者,按照手术路径不同分为对照组与研究组,每组40例。对照组实施LM治疗,研究组实施顺行VM治疗。对比两组围术期相关指标、并发症、术后肌瘤残留、复发情况及月经恢复情况。结果研究组手术时间、术后首次排气、首次排便时间及肠鸣音恢复时间均短于对照组,术中出血量少于对照组,差异有统计学意义(P<0.05);两组肌瘤剔除个数比较,差异无统计学意义(P>0.05)。两组术后并发症发生率比较,差异无统计学意义(P>0.05)。研究组术后肌瘤残留率[5.00%(2/40)]、术后肌瘤复发率[0(0/40)]、月经恢复正常率[95.00%(38/40)]与对照组的[5.00%(2/40)、7.50%(3/40).90.00%(36/40)]比较,差异无统计学意义(P>0.05)。结论LM与顺行VM治疗UM中具有创伤小、残留率少、复发率及并发症发生率低等优势,均可促进患者月经恢复正常,但顺行式VM手术时间较短,术中出血量较少,患者术后胃肠功能可尽早恢复。

Objective To investigate the application value of anterograde vaginal myomectomy(VM)and laparoscopic myomectomy(LM)in the treatment of uterine myoma(UM).Methods 80 UM patients who underwent surgical treatment were selected and divided into control group and study group according to different surgical paths,with 40 cases in each group.The control group was treated with LM,and the study group was treated with anterograde VM.The perioperative indicators,complications,postoperative myoma residue,recurrence and menstrual recovery were compared between the two groups.Results The operation time,first exhaust time,first defecation time and recovery time of bowel sounds in the study group were shorter than those in the control group,and the intraoperative blood loss was less than that in the control group,and the differences were statistically significant(P<0.05).There was no significant difference in the number of myomectomy between the two groups(P>0.05).There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).The postoperative myoma residual rate[5.00%(2/40)],postoperative myoma recurrence rate[0(0/40)],and normal menstruation rate[95.00%(38/40)]in the study group were compared with those in the control group[5.00%(2/40),7.50%(3/40),90.00%(36/40)].There was no significant difference(P>0.05).Conclusion LM and anterograde VM have the advantages of less trauma,residual rate,recurrence rate and low complications in the treatment of UM.Both of them can promote the recovery of menstruation.However,the operation time of anterograde VM is shorter,the amount of intraoperative bleeding is less,and the gastrointestinal function of patients can be recovered as soon as possible.