子宫肌瘤伴糖尿病患者实施腹腔镜手术与开腹手术治疗的应用效果及影响

Effectiveness and Influence of the Application of Laparoscopic Versus Open Surgical Treatment in Patients with Uterine Fibroids with Diabetes Mellitus

目的:评价子宫肌瘤伴糖尿病患者实施腹腔镜手术与开腹手术治疗的应用效果及影响。方法:从2019年1月—2020年7月鹿邑真源医院妇科就诊的子宫肌瘤伴糖尿病患者中抽选出92例作为研究对象,按照临床手术方式的不同分为对照组和观察组,每组各46例。对照组实施开腹手术治疗,观察组实施腹腔镜手术治疗,对比两组患者手术相关指标、不良妊娠结局、肌瘤残留率、肌瘤复发率及并发症情况。结果:观察组患者的手术时间、住院时间、术后下床活动时间、排气时间、手术切口长度等均短于对照组,其出血量明显少于对照组,差异有统计学意义(t=3.5266、13.3653、7.0182、10.2599、42.8142、9.7723,P<0.05);观察组患者术后的不良妊娠结局、肌瘤残留情况、肌瘤复发情况以及并发症发生率均显著比对照组低,差异有统计学意义(χ^(2)=4.0390、4.1820、4.9290,P<0.05);术前两组患者血糖水平差异不大,术后观察组患者的血糖水平变化幅度低于对照组,差异有统计学意义(t=11.6858、5.0519,P<0.05)。结论:临床治疗子宫肌瘤合并糖尿病选择腹腔镜手术切除的根治效果好,术中出血少,损伤程度轻,疾病复发的概率低,其安全性和有效性均优于开腹手术。

Objective:To evaluate the effectiveness and impact of the application of laparoscopic surgery versus open surgical treatment in patients with uterine fibroids with diabetes mellitus.Methods:90 patients with uterine fibroids with diabetes mellitus attending the hospital from January 2019 to July 2020 were selected for the study,and divided into two groups according to the clinical procedure.The control group was treated with open surgery,and the observation group was treated with laparoscopic sur⁃gery.Surgery-related indicators,adverse pregnancy outcomes,residual myoma rate,myoma recurrence rate and complications were compared between the two groups.Results:The patients in the observation group had shorter operative time,hospital stay,postoperative bed activity time,exhaustion time,and surgical incision length than the control group,and their bleeding volume was significantly less than that of the control group,and the difference was statistically significant(t=3.5266,13.3653,7.0182,10.2599,42.8142,9.7723,P<0.05).The incidence of adverse pregnancy outcome,residual myoma,recurrence of myoma and complications in the ob⁃servation group was lower than that in the control group,and the difference was statistically significant(χ^(2)=4.0390,4.1820,4.9290,P<0.05).The difference in blood glucose levels between the two groups before surgery was not significant,and the magnitude of change in blood glucose levels of patients in the observation group after surgery was lower than that of the control group,and the difference was statistically significant(t=11.6858,5.0519,P<0.05).Conclusion:Clinical treatment of uterine fibroids combined with diabetes mellitus chooses laparoscopic surgical resection with good radical effect,less intraoperative bleeding,less degree of injury,and less probability of disease recurrence,and its safety and effectiveness are better than open surgery.