摘要
目的探讨子宫肌瘤剔除的最佳术式,了解腹腔镜下子宫肌瘤剔除术与开腹子宫肌瘤剔除术的优缺点,从而制订合理的手术方案。方法选择北京市通州区妇幼保健院2010年5月至2011年5月收治的腹腔镜下子宫肌瘤剔除术患者108例为腹腔镜组,2009年1月至2011年5月随机抽取的134例开腹子宫肌瘤剔除术患者为开腹组。对两组患者肌瘤大小、部位及数目与手术时间、术中出血的关系,术后肛门排气时间、下床活动时间、术后病率,及术后随访情况进行观察及比较。结果在子宫肌瘤的种类、部位相同的条件下,腹腔镜组较开腹组手术时间明显延长,术中出血明显减少,差异有统计学意义(P<0.05)。两组均随着肌瘤的增大,术中出血增多,肌壁间肌瘤较浆膜下肌瘤手术时间延长,多发肌瘤较单发肌瘤手术时间延长,而两组浆膜下肌瘤的出血量、多发肌瘤出血量比较差异无统计学意义(P>0.05)。腹腔镜组术后肛门排气时间、下床活动时间均早于开腹组,术后病率小于开腹组,差异均有统计学意义(P<0.01)。结论腹腔镜下子宫肌瘤剔除术具有创伤小、术中出血少、术后恢复快等优点,具有广阔的发展前景,但有其局限性,与开腹手术相比各有优缺点。
Objective To explore the best surgical method of myomectomy,understand the merits and faults of laparoscopic myomectomy and open myomectomy,and reasonably make surgery plan.Methods One hundred and eight cases who underwent laparoscopic myomectomy from May 2010 to May 2011 and 134 cases who underwent open myomectomy from January 2009 to May 2011 from Tongzhou Maternal Child Health Hospital of Beijing were selected and comparatively studied.The relationship of the size,location and number of myoma and operating time,intraoperative bleeding,postoperative anal exhaust time,out-of-bed activity time,postoperative disease rate,and postoperative follow-up of the two groups were observed and compared.Results Compared with the open myomectomy group,under the same conditions of site and type of uterine leiomyoma,the operating time of laparoscopic myomectomy group was extended significantly,and intraoperative bleeding decreased significantly,the differences were statistically significant（P 0.05）.The intraoperative bleeding of the two groups increased with myoma increase,the operating time of intramural myoma was longer than that of subserous myoma,the operating time of multiple myoma was longer than that of single myoma,but there were no significant differences in intraoperative bleeding between subserous myoma and multiple myoma of the two groups（P 0.05）.There were significant differences in postoperative anal exhaust time,out-of-bed activity time and postoperative disease rate between the two groups（P 0.01）.Conclusion laparoscopic myomectomy has the advantages of less trauma,less intraoperative bleeding and faster postoperative recovery,and has broad prospects for development,but it also has its limitations and pros and cons compared to the open surgery.
出处
《医学综述》
2013年第16期3066-3068,共3页
Medical Recapitulate
关键词
子宫肌瘤
腹腔镜
剔除术
Hysteromyoma
Laparoscope
Myomectomy
