腹腔镜下子宫肌瘤切除术120例临床观察

The clinical observation of 120 cases with hysteromyomectomy under the laparoscopy

目的 :探讨腹腔镜下子宫肌瘤切除术的手术方法、适应证、术后疗效及影响因素。方法 :回顾分析腹腔镜下 1 2 0例子宫肌瘤切除术的临床资料 ,其中单发肌瘤 79例 ,多发肌瘤 4 1例 ,单发肌瘤包括肌壁间肌瘤 4 2例 ,浆膜下肌瘤 33例 ,阔韧带肌瘤 4例。结果 :除 1例阔韧带肌瘤靠近子宫动脉中转开腹外 ,余者手术均获成功 ,术中出血 92 2 0± 98 2 1ml ;手术时间 1 0 9 72± 4 5 0 7min ;术后肛门排气时间 1 85± 0 35d ;无术后病率 ;术后住院 4 85± 1 75d ;无严重并发症。结论 :腹腔镜下子宫肌瘤切除术是目前较为理想、安全有效的保留子宫的手术方法。术中出血量和手术时间主要与肌瘤生长部位及其大小有关。

Objective:To explore the operative technique of hysteromyomectomy under the laparoscopy, its indication, post operative effect and affective factors.Methods:The clinical data of 120 cases with hysteromyomectomy under the laparoscopy were analyzed retrospectively. Of all the cases, single account was 79 patients for 65 percent ,included 42 cases of interparietal hysteromyoma, 33 cases of subserous hysteromyoma, 4 cases of hysteromyoma located on expanse ligamentum, and the multiple hysteromyomas was 41 patients account for 35 percent.Results: All patients' operations were very favoring and successful except for one patient due to her hysteromyoma close to womb artery. The bleeding quantity during operation averaged 92.20±98.21ml. The operative time averaged 109.72±45.07min. The time when the patient exhausted through apart from whose operation were 1.85±0.35 d.The hospitalization of post operative was 4.85±1.75d. No serious complication was found in these cases.Conclusions: The bleeding quantity during operation and the operative time are determined by the hysteromyoma's location and its size. The operation of hysteromyomectomy under the laparoscopy is the effective means to reserve womb nowadays.