宫腔镜与腹腔镜子宫肌瘤切除术治疗子宫黏膜下肌瘤的临床效果及安全性对比分析

Comparative Analysis of Clinical Efficacy and Safety of Hysteroscopy and Laparoscopic Myomectomy for the Treatment of Submucosal Uterine Fibroids

目的:对比分析宫腔镜与腹腔镜子宫肌瘤切除术治疗子宫黏膜下肌瘤的临床效果及安全性。方法:选择辽阳市中心医院2019年5月~2021年10月收治的72例子宫黏膜下肌瘤患者,随机分为宫腔镜组、腹腔镜组各36例。宫腔镜组行宫腔镜子宫肌瘤切除术,腹腔镜组行腹腔镜子宫肌瘤切除术。对比两组手术情况、卵巢功能、免疫功能、并发症、肌层愈合率和复发率。结果:宫腔镜组术中出血量(32.56±7.49)mL低于腹腔镜组,手术时间(38.50±8.58)min、肛门排气时间(13.20±2.95)h、住院时间(3.33±0.70)d均短于腹腔镜组(P<0.05);两组并发症发生率对比,宫腔镜组易发生液体灌流综合征、宫颈损伤、子宫穿孔,腹腔镜组易发生肠梗阻、感染;宫腔镜组肌层愈合率高于腹腔镜组(P<0.05),两组复发率为0。结论:宫腔镜与腹腔镜子宫肌瘤切除术治疗子宫黏膜下肌瘤均具有一定疗效,且宫腔镜手术创伤更小,术后恢复更快,对患者卵巢功能及免疫功能影响更小。

Objective:Efficacy and safety of hysteroscopy and laparoscopic myomectomy for submucous myoma of uterus.Methods:72 patients with uterine submucosal fibroids admitted to Liaoyang Central Hospital from May 2019 to October 2021 were reviewed and randomly divided into hysteroscopy group and laparoscopy group with 36 cases in each group.Hysteroscopic myomectomy was performed in hysteroscope group and laparoscopic myomectomy was performed in laparoscopy group.The operation situation,ovarian function,immune function,complications,muscle layer healing rate and recurrence rate were compared between the two groups.Results:The intraoperative blood loss in hysteroscopy group was(32.56±7.49)mL lower than that in laparoscopy group,and the operation time(38.50±8.58)min,the anal exhaust time(13.20±2.95)hours and hospitalization time(3.33±0.70)days were both shorter than those in the control group(P<0.05).Comparison of the incidence of complications between the two groups:the hysteroscopic group was more prone to fluid perfusion syndrome,cervical injury,and uterine perforation,while the laparoscopic group was more prone to intestinal obstruction and infection;The healing rate of myometrium in hysteroscopy group was higher than that in laparoscopy group(P<0.05),and the recurrence rate of both groups was 0.Conclusion:Both hysteroscopy and laparoscopic myomectomy have certain curative effects on submucous myoma of uterus,and hysteroscopy has less trauma,faster postoperative recovery and less influence on ovarian function and immune function of patients.