腹腔镜子宫肌瘤剔除术治疗子宫肌瘤的疗效及安全性分析

Analysis of the efficacy and safety of laparoscopic myomectomy in the treatment of uterine fibroids

目的分析腹腔镜子宫肌瘤剔除术(LM)治疗子宫肌瘤(UF)的临床疗效。方法选取60例UF患者,将其根据随机数字表法分为两组,每组30例。对照组患者采用开腹子宫肌瘤剔除术(TARM)治疗,试验组患者采用LM治疗。比较两组患者手术指标、卵巢功能及并发症发生情况。结果试验组术中出血量(202.14±41.37)ml,较对照组(344.12±56.23)ml少,手术时间(71.43±15.24)min、首次下床时间(22.10±3.41)h、恢复排气时间(16.54±2.35)h、住院时间(4.23±1.02)d,均较对照组的(93.25±20.12)min、(32.26±6.55)h、(23.16±4.22)h、(6.23±2.11)d短(P<0.05),两组肌瘤残留个数比较,差异无统计学意义(P>0.05)。术后7d,试验组雌二醇(E_(2))水平较对照组高,卵泡刺激素(FSH)、促黄体生成素(LH)水平较对照组低(P<0.05)。试验组并发症发生率3.33%低于对照组的23.33%(P<0.05)。结论LM、TARM治疗UF效果相当,但LM手术指标更佳,卵巢损伤更轻,并发症发生率更低。

Objective To analyze the clinical effect of laparoscopic myomectomy(LM)in the treatment of uterine fibroids(UF).Methods 60 UF patients were selected and divided into two groups with 30 cases in each group according to random number table method.The control group was treated with transabdominal resection of myoma(TARM),and the experimental group was treated with LM.The surgical indexes,ovarian function and complications were compared between the two groups.Results The experimental group's intraoperative blood loss(202.14±41.37)ml was less than(344.12±56.23)ml of the control group,the operation time was(71.43±15.24)min,the first time of getting out of bed was(22.10±3.41)h,the recovery time of exhaust gas was(16.54±2.35)h,and the hospital stay was(4.23±1.02)d,shorter than(93.25±20.12)min,(32.26±6.55)h,(23.16±4.22)h,(6.23±2.11)d in the control groups,and there was no statistical significance in the number of residual fibroids between the two groups(P>0.05).After 7 days of operation,the estradiol(E_(2))level of experimental group was higher than that of control group,and the levels of follicle stimulating hormone(FSH)and luteinizing hormone(LH)of experimental group were lower than those of control group(P<0.05).The complication rate of 3.33%in experimental group was lower than 23.33%in control group(P<0.05).Conclusion The effect of LM and TARM in the treatment of UF is similar,but LM has better surgical indicators,less ovarian injury and lower complication rate.