经阴道子宫肌瘤剔除术及术后功能恢复观察

Investigation of vaginal myomectomy and recovery after operation

目的探讨经阴道子宫肌瘤剔除术的效果 ,与经腹腔子宫肌瘤剔除术进行比较。方法将符合手术指征的 80例子宫肌瘤患者随机分成A、B两组各 40例 ,A组行经阴道子宫肌瘤剔除术 ,B组行经腹腔子宫肌瘤剔除术 ,比较两组患者的手术效果和术后恢复情况。结果A组 40例患者中 3 8例 (95 % )成功经阴道剔除子宫肌瘤 ,2例改行开腹手术 ;B组 40例患者全部完成肌瘤剔除术。两种手术方式的平均手术时间、平均术中出血量、术后患者的平均最高体温、平均排气时间和平均术后住院天数均无显著性差异 (P >0 .0 5 )。两组患者术后均无血肿形成。经平均 6个月随访 ,因月经过多手术者 ,症状全部改善 ;因盆腔痛手术者 ,A组有5 0 %症状改善 ,B组有 66%症状改善。与B组患者比较 ,A组患者的康复速度更快 ,对手术效果更满意 ,且无术后腹部伤口疤痕带来的疼痛等不适。结论经阴道子宫肌瘤剔除术与经腹腔子宫肌瘤剔除术的手术效果相似 ,但前者手术创伤小 ,术后并发症少 ,康复快 ,是一种值得推广应用的微创伤手术方式。

ObjectiveTo explore the effect of vaginal myomectomy and compared with abdominal myomectomy.Methods80 patients with myomectomy were randomly divided into two groups with 40 cases in each group. Patients of the group A were operated by vaginal myomectomy, that of the group B were operated by abdominal myomectomy. Effects of operation and recovery of two groups were compared.ResultsIn the group A, 38 cases (95%) successfully undertook vaginal myomectomy, whereas all 40cases completed the planned surgery in the group B. There were no significant differences on the mean operating time, blood lose during operation, mean maximal postoperative temperature and average postoperative hospital stay between two groups ( P>0.05). There was no uterine hematomas developed postoperatively in all patients. The symptoms were mostly relieved after 6 moths'follow-up and patients of the group A showed a rapid recovery time and lower rate of complaints.ConclusionVaginal myomectomy can be performed in selected patients with low complications, good short-term effect, minimum operative injury compared with abdominal myomectomy.