宫腔镜子宫肌瘤电切术与腹腔镜子宫肌瘤剔除术疗效比较

Comparison of the Efficacy of Hysteroscopic Myomectomy and Laparo⁃scopic Myomectomy for Uterine Fibroids

目的 对比分析子宫肌瘤采取宫腔镜下子宫肌瘤电切术(transcervical resection of myoma, TCRM)与腹腔镜下子宫肌瘤剔除术(laparoscopic lyomectomy, LM)的疗效。方法 回顾性选取2020年1月—2023年8月昆山市第二人民医院收治的84例子宫肌瘤患者的临床资料,按手术方案不同分为观察组和对照组,各42例。观察组采用TCRM治疗,对照组采用LM治疗。对比两组手术指标、卵巢储备功能及术后并发症发生情况。结果 观察组的手术时间为(42.41±9.05)min、术中出血量为(74.12±20.06)mL、术后排气时间为(14.56±3.06)h、住院时间为(4.55±0.78)d,均优于对照组的(61.84±12.35)min、(95.61±22.36)mL、(19.80±5.12)h、(6.30±1.28)d,差异有统计学意义(t=8.224、4.636、5.693、7.566,P均<0.05)。两组患者的雌二醇、黄体生成素和卵泡刺激素对比,差异无统计学意义(P均>0.05)。观察组术后并发症总发生率为4.76%(2/42),低于对照组的19.05%(8/42),差异有统计学意义(χ^(2)=4.087,P<0.05)。结论 LM和TCRM治疗子宫肌瘤均能取得良好效果,且对卵巢功能影响较小,但TCRM手术时间更短,术后康复更快,并发症较少。

Objective To compare and analyze the efficacy of transcervical resection of myoma(TCRM)and laparo-scopic myomectomy(LM)in the treatment of uterine fibroids.Methods The clinical data of eight-four patients with uterine fibroids admitted to Kunshan Second People's Hospital from January 2020 to August 2023 were retrospec-tively selected and divided into observation group and control group according to different surgical schemes,with forty-two cases in each group.The observation group was treated with TCRM,and the control group was treated with LM.The surgical indicators,ovarian reserve function and postoperative complications were compared between the two groups.Results In the observation group,the operation time was(42.41±9.05)min,the intraoperative blood loss was(74.12±20.06)mL,the postoperative exhaust time was(14.56±3.06)h,and the hospitalization time was(4.55±0.78)d,which were better than those in the control group(61.84±12.35)min,(95.61±22.36)mL,(19.80±5.12)h,(6.30±1.28)d,the differences were statistically significant(t=8.224,4.636,5.693,7.566,all P<0.05).There was no significant differ-ence in estradiol,luteinizing hormone and follicle stimulating hormone between the two groups(all P>0.05).The total incidence of postoperative complications in the observation group was 4.76%(2/42),which was lower than 19.05%(8/42)in the control group,and the difference was statistically significant(χ^(2)=4.087,P<0.05).Conclusion Both LM and TCRM can achieve good results in the treatment of uterine fibroids and have little effect on ovarian function,but TCRM has shorter operation time,faster postoperative recovery and fewer complications.