对比分析腹腔镜手术和宫腔镜手术剔除子宫壁间肌瘤的疗效

Comparative Analysis of the Effect Between Laparoscopic and Hysteroscopic Myomectomy

目的对比分析宫腔镜和腹腔镜手术剔除子宫壁间肌瘤的临床效果。方法整群选取该院2013年3月—2015年4月收治的314例需要剔除子宫壁间肌瘤患者作为研究对象,其中腹腔镜组196例,宫腔镜组118例,分别行腹腔镜下子宫肌瘤剔除术和对应的宫腔镜下子宫肌瘤电切术,并比较两组术后的各项指标就总体疗效。结果根据该院的统计分析看来,在术中出血量、平均手术时间及血红蛋白减低程度方面的对比显示,宫腔镜组均少于腹腔镜组(P<0.05);此外,在术中转开腹率、术后月经改善率和发热率方面,两组的对比差异无统计学意义(P>0.05);经该院后续对168例腹腔镜组患者及90例宫腔镜组患者随访发现,在对应的1、3、6个月的肌层完全愈合率方面,两组对比差异无统计学意义(P=0.709,χ2=0.139)。术后妊娠患者均未出现妊娠期子宫破裂的情况。结论对于子宫壁间肌瘤患者的治疗而言,宫腔镜和腹腔镜手术均安全可靠,相比之下,宫腔镜下子宫肌瘤电切术术中出血少,接受治疗的患者能在很短时间内恢复,该院还发现对有生育要求的患者而言,显然宫腔镜下子宫肌瘤电切术更优。

Objective To compare and analyze the clinical effect between hysteroscopic and laparoscopic myomectomy. Methods314 cases underwent myomectomy in our hospital from March 2013 to April 2015 were selected as the subjects and divided into the laparoscopic group(196 cases) and hysteroscopic group(118 cases). Patients in the laparoscopic group were given laparoscopic myomectomy, while those in the hysteroscopic group were given hysteroscopic myomectomy. And the postoperative indexes and overall response rate were compared between the two groups. Results The result of statistical analysis of our hospital showed that,compared with the laparoscopic group, the hysteroscopic group had less intraoperative blood loss, shorter average duration of operation and less reduction in the level of hemoglobin(P<0.05). The differences in intraoperative transferring to laparotomy, postoperative improvement in menstruation and incidence of fever between the two groups were not statistically significant(P>0.05). The follow-up of the 168 cases in the laparoscopic group and 90 cases in the hysteroscopic group showed that, the differences in the 1-month, 3-month and 6-month complete healing rate of muscle layer between the two groups were not statistically significant(P=0.709, χ2=0.139). No uterine rupture during pregnancy occurred in the patients who had pregnancy after surgery. Conclusion For patients with intramural uterine fibroid, both hysteroscopic and laparoscopic myomectomy are safe and reliable, but hysteroscopic myomectomy has less intraoperative blood loss and quicker recovery, so it is better for those patients with fertility requirement found by our hospital.