腹腔镜手术与经阴道手术治疗子宫肌瘤的效果比较

Comparison of clinical effects of laparoscopic surgery and transvaginal surgery in the treatment of hysteromyoma

目的分析子宫肌瘤患者采用腹腔镜手术与经阴道手术治疗的临床疗效。方法选取80例子宫肌瘤患者,根据手术方法不同分为腹腔镜组(43例)与经阴道组(37例)。比较两组手术情况、术后恢复情况、性激素水平、并发症及复发率。结果腹腔镜组术中出血量少于经阴道组,手术时间、首次排气时间、首次下地时间及住院时间均短于经阴道组,差异具有统计学意义(P<0.05)。与手术前相比,术后5 d两组血清促黄体生成素(LH)、卵泡刺激素(FSH)水平升高,但经阴道组高于腹腔镜组;血清雌二醇(E2)水平降低,但经阴道组低于腹腔镜组,差异具有统计学意义(P<0.05)。腹腔镜组术后3个月内并发症发生率和术后6个月复发率低于经阴道组,差异具有统计学意义(P<0.05)。结论子宫肌瘤患者采用腹腔镜手术治疗临床效果优于经阴道手术,预后良好。

Objective To analyze the clinical efficacy of laparoscopic and transvaginal surgery in the treatment of hysteromyoma.Methods A total of 80 patients with uterine fibroids were retrospectively selected as the observation objects of this study.According to different types of surgery,43 cases were divided into laparoscopic group and 37 cases of transvaginal group.The operation conditions,postoperative recovery,sex hormone levels,complications and recurrence rates were compared between the two groups.Results The amount of intraoperative blood loss in the laparoscopic group was less than that in the transvaginal group,and the operation time,first exhaust time,first ground time and hospital stay were shorter than those in the transvaginal group,with statistically significant differences(P<0.05).Serum luteinizing hormone(LH)and follicle stimulating hormone(FSH)levels in the two groups were increased 5 days after operation compared with before operation,but the levels in the transvaginal group were higher than those in the laparoscopic group.The level of serum estradiol(E2)in transvaginal group was lower than that in laparoscopic group,and the difference was statistically significant(P<0.05).The incidence of complications 3 months after operation and recurrence rate 6 months after operation in the laparoscopic group were lower than those in the transvaginal group,the differences were statistically significant(P<0.05).Conclusion The clinical effect of laparoscopic surgery for hysteromyoma is better than that of transvaginal surgery,the prognosis is good.