子宫肌瘤剔除术三种术式临床结局分析

目的:探讨子宫肌瘤剔除术的三种术式及其适应证。方法:回顾分析皖南医学院附属弋矶山医院2007年2月～2009年4月同一术者腹腔镜下子宫肌瘤剔除术54例、阴式子宫肌瘤剔除术28例与同期行开腹子宫肌瘤剔除术80例的临床资料,选出相匹配的组别分别进行比较,分析围手术期资料特点。结果:总体比较时,腹腔镜组的手术出血量长于开腹组和阴式组,P<0.05。分组比较时,在肌瘤A(小肌瘤)组:阴式组和腹腔镜组的住院时间明显短于开腹组,阴式组费用明显少于腹腔镜组,差异有统计学意义(P<0.05);在肌瘤B(大肌瘤)组,腹腔镜组所需手术时间最长,住院费用最高,但胃肠功能恢复时间、术后住院时间短于开腹组,阴式组术后住院时间同样短于开腹组,P均<0.05。在多发性肌瘤组,腹腔镜组胃肠功能恢复时间与开腹组相仿,差异无统计学意义。结论:腹腔镜下及阴式肌瘤剔除术均为微创术式,两种术式均安全可靠;阴式肌瘤剔除术住院费用更少;而多发(肌壁间肌瘤≥4个)、粘膜下肌瘤、巨大肌瘤以及盆腔粘连严重者首选开腹肌瘤剔除术。

Clinical outcomes of three approaches to myomectomy

Objective:To assess the advantages, disadvantages and indications of transabdominal myomectomy(TAM), laparoscopic myomectomy(LM) and transvaginal myomectomy(TVM).Methods:The clinical data were retrospectively analyzed in 80, 54 and 28 cases undergone TAM, LM or TVM, respectively, by the same gynecologist during Feb. 2007 and Apr. 2009. The corresponding subjects were chosen for comparison. Results:Generally, intraoperative blood loss in patients by LM was greater than that of the subjects by TAM or TVM(P<0....