腹腔镜下子宫肌瘤剔除术与开腹手术的临床疗效对比

Clinical comparative study of laparoscopic myomectomy and abdominal operation

目的:探讨腹腔镜下子宫肌瘤剔除术与开腹手术的临床疗效。方法:2012年1月-2014年11月收治子宫肌瘤患者116例,随机分为观察组和对照组,各58例,观察组采用腹腔镜下子宫肌瘤剔除术,对照组行传统常规开腹手术,对两组患者的临床资料进行回顾性分析,分析2种手术方法的临床治疗效果。结果:观察组术后有效率92.3%,明显优于对照组75.6%,两组间差异存在统计学意义(P<0.05)。腹腔镜组的手术时间及住院费用明显多于对照组(P<0.05);而手术时间、术中出血量、肛门的排气时间、住院时间均要少于对照组,两组之间差异有统计学意义(P<0.05),两组患者复发情况差异无统计学意义(P>0.05)。观察组和对照组术后雌激素水平均下降,观察组术后雌激素及卵泡雌激素水平显著高于对照组,其差异有统计学意义(P<0.05)。结论:腹腔镜治疗子宫肌瘤疗效显著,具有手术并发症少、保持了盆底结构的完整性、手术时间短、创伤性小、术中出血量少、粘连少、切口美观等诸多优点。值得临床推广应用,但其并不能代替开腹手术。

Objective:To investigate the clinical efficacy of laparoscopic myomectomy and abdominal operation.Methods: 116 patients with uterine fibroids were selected from January 2012 to November 2014.They were randomly divided into the observation group and the control group with 58 cases in each group.The observation group were treated with laparoscopic myomectomy,and the control group received traditional conventional open operation.The clinical datas of two groups were analyzed retrospectively,and we analyzed the clinical treatment effect of two kinds of operation methods.Results:The efficiency of the observation group patients after the operation was 92.3%,which was significantly better than that of the control group 75.6%, and the difference was statistically significant(P＜0.05).The operation time and hospitalization cost of patients in the laparoscopic group was higher than those of the control group(P＜0.05);and the operation time,bleeding volume,anal exhaust time, hospitalization time were lower than those of the control group,and with significant differences between the two groups(P＜0.05). There were no statistically significant differences between the two groups of patients relapse(P＞0.05).The estrogen levels of the observation group and the control group patients were reduced;the estrogen and follicle estrogen level of the observation group was significantly higher than those of the control group after the operation;the difference was statistically significant(P＜0.05). Conclusion:The curative effect of laparoscopic in the treatment of uterine fibroids is significantly.It has many advantages which are worthy of clinical popularization and application,such as the less operation complications,maintained the integrity of the pelvic floor structure,the operation time is short,traumatic small,less bleeding,sticky even less,incision appearance and so on.but it cannot replace open surgery.