阴道超声引导下腹腔镜手术治疗子宫肌瘤的临床效果及对肌瘤残留、复发情况的研究

Study on the clinical effect of vaginal ultrasound-guided laparoscopic surgery in the treatment of uterine fibroids and the residual and recurrence of fibroids

目的 探讨阴道超声引导下腹腔镜手术治疗子宫肌瘤的临床效果及对肌瘤残留、复发情况的影响。方法 回顾性分析诸暨市妇幼保健院2020年1月至2023年1月接诊的78例行子宫肌瘤手术的女性患者病历资料,根据手术方法不同,将患者分为观察组、对照组各39例。对照组采用腹腔镜剔除术治疗,观察组采用经阴道超声引导下腹腔镜剔除术治疗。记录两组临床效果、围术期指标,并比较两组术后3 d、6个月、12个月肌瘤残留、复发,并记录术后并发症。结果 两组的术中出血量、术后排气时间、切口愈合时间、住院时间及术后并发症的总发生率比较,差异无统计学意义(P>0.05),观察组的手术时间明显长于对照组,肌瘤残留、复发明显低于对照组(P<0.05)。结论 阴道超声引导下腹腔镜手术治疗子宫肌瘤患者的临床效果显著,能降低肌瘤残留和术后复发。

Objective To investigate the clinical effect of laparoscopic surgery guided by vaginal ultrasound in the treatment of uterine fibroids and its influence on the residual and recurrence of fibroids.Methods The medical records and data of 78 female patients undergoing uterine fibroid surgery admitted to our hospital from January 2020 to January 2023 were retrospectively analyzed,according to different surgical methods,the patients were divided into the observation group and the control group,39 cases in each group.The control group was treated with laparoscopic resection,and the observation group was treated with transvaginal ultrasound-guided laparoscopic resection.The clinical results and perioperative indexes of the two groups were recorded,and the residual and recurrence of leiomyosarcoma were compared between the two groups at 3 d,6 months,and 12 months after the operation,and the postoperative complications were recorded.Results The intraoperative bleeding,postoperative venting time,incision healing time,hospitalization time and the total incidence of postoperative complications of the two groups showed no statistically significant difference(P>0.05).The operative time of the observation group was significantly longer than that of the control group,and the residual leiomyosarcoma and recurrence of leiomyosarcoma were significantly lower than that of the control group(P<0.05).Conclusion Patients with uterine fibroids are treated with vaginal ultrasound-guided laparoscopic surgery with remarkable clinical results,which can reduce residual fibroids and postoperative recurrence.