摘要
目的探讨经腹子宫肌瘤剔除术(TAM)、经阴道子宫肌瘤剔除术(TVM)、腹腔镜子宫肌瘤剔除术(LM)的临床特点及临床价值。方法对2009年7月～2010年12月安徽医科大学附属第二医院因子宫肌瘤需行子宫肌瘤剔除术患者的临床资料进行回顾性分析,其中TAM组60例,TVM组49例,LM组52例,观察三组手术时间、术中出血情况、术后镇痛、术后病率和住院时间。结果 LM组手术时间(105.5±34.6)min分别较TAM组(73.3±25.2)min、TVM组(81.4±30.6)min延长(P<0.05),而后两组比较差异无统计学意义(P>0.05);术中出血量TAM组(241±45)ml分别显著高于TVM组的(188±50)ml和LM组的(197±48)ml(P<0.05),后两组比较差异无统计学意义(P>0.05);围手术期TAM组术后镇痛率(81.7%)分别显著高于TVM组(35.9%)、LM组(30.8%)(P<0.01),后两组比较差异无统计学意义(P>0.05);住院时间TAM组(8.3±1.7)d与TVM组(5.8±1.6)d、LM组(5.4±1.8)d比较差异有统计学意义(P<0.05),后两组比较差异无统计学意义(P>0.05)。三组术后病率比较差异无统计学意义(P>0.05)。结论 TVM术式和LM术式均具有术中出血少、术后疼痛轻、术后病率低、住院时间短等优点,但TVM术式手术费用更低,LM术式对手术器械及术者镜下缝合技术要求高,TAM术式适应证最广泛,临床应根据不同情况选择不同的子宫剔除术以达到最佳治疗效果。
Objective To compare clinical characteristics and value in Transabdominal Myomectomy,Transvaginal Myomectomy and Laparoscopic Myomectomy.Methods From July 2009 to December 2010,60 women undergoing TAM,49 women undergoing TVM and 52 women undergoing LM were studied retrospectively in Dapartment of Gyanaecology And Obstetrics,the Second Affiliated Hospital of Anhui Medical University.the operative time,blood loss,hospital stay,postoperative analgesic and postoperative morbidity were compared and analyzed.Results LM had significantly longer operative time than TAM and TVM（P0.05）.Blood loss in TAM group was significantly greater than those in TVM or LM（P0.05）.The postoperative analgesic rate in TAM group was higher than those in TVM or LM（P0.05）.Hospital stay days in TAM was significantly longer than in TVM or LM（P0.05）.Postoperative morbidity was not significantly different in the 3 groups（P0.05）.Conclusion Both TVM and LM have advantages over TAM in reducing blood loss,postoperative pain and morbidity,shortening hospital stay.But TVM costs much less,LM has dependent on surgical insturments and the technical ability of surgeon suture under the whole laparoscope,TAM has the most extensive adaptation disease.It is reasonable to choose the pattern of hysterectomy according to the patients practical condition.
出处
《中外医学研究》
2012年第5期8-10,共3页
CHINESE AND FOREIGN MEDICAL RESEARCH
