3种子宫肌瘤剔除术的临床比较研究

目的:探讨悬吊式免气腹腹腔镜下子宫肌瘤剔除术的临床应用。方法:选取在我院行免气腹腹腔镜下子宫肌瘤剔除术(免气腹组)病人30例、腹腔镜下子宫肌瘤剔除术(气腹组)病人30例及类似条件下行腹式子宫肌瘤剔除术(开腹组)病人30例的病例资料进行回顾性对照研究,比较3组手术时间、术中出血量、术后首次肛门排气时间、术后体温恢复正常时间、术后住院时间。结果:开腹组手术时间短于气腹组和免气腹组,但术后首次排气时间、术后住院天数、体温恢复时间明显长于气腹组及免气腹组,差异有统计学意义(P<0.05)。结论:3组手术各有优、缺点。免气腹腹腔镜手术作为一种治疗子宫肌瘤的微创手术,具有安全、经济、操作简便、易于掌握,手术适应症宽等优点,具有广阔的发展前景。

Comparative study on three ways of hysteromyomectomy

Objective：To compare the effectiveness of gasless laparoscopy and CO2-insufflated pneumoperitoneal laparoscopy in hysteromyomectomy.Methods：A total of 90 patients with uterine myoma treated in our hospital were selected,gasless laparoscopy（GLM） was performed in 30 patients,pneumoperitoneal laparoscopy（LM） were employed in 30,and under the same condition transabdominal hysteromyomectomy was used in 30 patients.The operation time,intraoperative bleeding volume,postoperative recovery time of gastrointestinal function,temperature recovery time and hospitalization duration were compared among the three groups.Results：The mean operation time was shorter in the transabdominal group than that in the LM group and GLM group,but postoperative recovery time of gastrointestinal,function temperature recovery time and hospitalization duration were significantly longer in the LM group and GLM group（P0.05）.Conclusions：There are advantages and disadvantages in three ways of hysteromyomectomy,respectively.Gasless laparoscopy is safe,economic,easy to be operated and mastered and of more surgery indications.It is prosperous in clinical application.