不同手术方式子宫肌瘤切除术对妊娠结局的影响研究

The effect of different surgical methods on the pregnancy outcome

目的：观察不同手术方式子宫肌瘤切除术对妊娠结局的影响。方法：回顾性分析2013年6月～2014年6月在我院接受子宫肌瘤切除术的120例患者的临床及随访资料，其中经腹腔镜切除者65例，采用开腹切除者55例，两组患者术后均给予为期1年的随访。比较两组患者围手术期一般情况、术后妊娠结局以及术后子宫瘢痕愈合、盆腔粘连情况。结果：腹腔镜组患者出血量（86.28±8.86）ml，明显较开腹组少，住院时间为（4.21±1.05）天，明显较开腹组短，而两组患者手术时间无明显差别；两组患者术后发生盆腔粘连的情况存在显著差异：开腹组患者术后发生中、重度盆腔粘连的例数明显多于腹腔镜组，差异有统计学意义；腹腔镜组和开腹组患者术后自然妊娠率无明显差别，两组自然妊娠的患者中，流产、早产、正常分娩和剖宫产的例数无明显差别。结论：虽然不同的手术方式对妊娠结局无明显影响，但腹腔镜下子宫肌瘤切除术创伤较开腹手术小，可缩短患者住院时间，且降低术后盆腔粘连的发生率，具有较高的临床应用价值。

Objective To observe the effect of different surgical methods on the outcome of pregnancy. Methods A ret-rospective analysis was made on June 2013 to June 2014 in our hospital accepted clinical and follow-up data of 120 patients with uterine fibroids resection, 65 cases of the laparoscopic resection, 55 cases with abdominal resection, after operation, the patients in the two groups were given for a period of 1 year of follow-up. Compared with the two groups of patients in periopera-tive general, postoperative pregnancy outcome and postoperative uterine scar healing, pelvic adhesion. Results The amount of bleeding in patients with laparoscopic group(86.28+8.86)ml, significantly less than the open group, the length of stay was(4.21+1.05)days, significantly shorter than the open group, and two groups of patients with no significant difference in operation time;Two groups of patients after the occurrence of pelvic adhesions were significantly different:the laparoscopic group of patients with moderate and severe pelvic adhesions were significantly more than the open group, the difference was statistically signifi-cant;There was no significant difference in natural pregnancy rate between laparoscopic group and open surgery group. There were no significant differences in the number of abortion, premature birth, normal labor and cesarean section in the two groups of natural pregnancy . Conclusion Although different surgical methods on pregnancy outcome without significant influence, but laparoscopic uterine fibroids resection operation wound is smaller than open surgery, can shorten the hospitalization time, and reduce the incidence of postoperative pelvic adhesions, has high clinical application value.