阴式子宫肌瘤剔除术45例临床分析

目的探讨阴式子宫肌瘤剔除术的可行性、临床效果和安全性。方法回顾性分析2002年1月至2004年4月间,我院阴式子宫肌瘤剔除术患者45例(阴式组)及同期行腹式子宫肌瘤剔除术的患者45例(对照组)的临床资料,比较手术效果和术后恢复情况。结果平均手术时间、术中平均出血量阴式组为(76±21)min、(414±73)ml,对照组为(72±26)min、(404±68)ml,两组比较,差异均无统计学意义(P>0·05);而阴式组患者术后的平均排气时间(18±9)h]、术后平均住院时间(4·8±0·6)d]均明显短于对照组(31±8)h、(7·8±0·4)d],两组比较,差异有统计学意义(P<0·05)。两组患者术后平均随访6·8个月,因月经过多手术者,症状全部改善;与对照组比较,阴式组患者术后康复快,对手术效果更满意。结论阴式子宫肌瘤剔除术比腹式子宫肌瘤剔除术的手术效果好、创伤小、术后并发症少、康复快,是一种值得推广、应用的微创术式。

Clinical analysis of 45 cases of vaginal myomectomy

OBJECTIVE: To evaluate the feasibility, clinical effect and safety of vaginal myomectomy. METHOD: From January 2002 to April 2004, 45 cases treated by vaginal myomectomy were analyzed as the study group, and 45 cases treated by abdominal myomectomy during the same period in our hospital were selected as the control group. Effects of operation and recovery of two groups were compared. RESULTS: There were no significant differences in the mean operating time, blood loss during operation between the study group, (76 +/- 21) minutes, (414 +/- 73) ml and the control group, (72 +/- 26) minutes, (404 +/- 68) ml. In the study group, the mean recovery time of bowel function (18 +/- 9) hours and average postoperative hospital stay (4.8 +/- 0.6) days were shorter than in the control group (31 +/- 8) hours, (7.8 +/- 0.4) days. For two groups menorrhagia were relieved after 6.8 months' follow-up, patients in the study group recovered more rapidly and felt more satisfactory with the effect of operation than patients in the control group. CONCLUSION: Vaginal myomectomy can be performed in selected patients with minimum operative injury, low complications and good short-time effect compared with abdominal myomectomy.