子宫肌瘤剔除3种术式的临床比较

目的比较3种子宫肌瘤剔除术的临床效果和安全性。方法子宫肌瘤剔除术180例按手术方法不同分成3组:开腹子宫肌瘤术(TAM)60例、腹腔镜下子宫肌瘤剔除术(LM)60例和阴式子宫肌瘤剔除术(TVM)60例,比较手术效果和术后恢复情况。结果 TVM手术时间(69.58±26.72)min、TAM(88.93±31.07)均小于LM(115.63±35.12)min(t=2.345,t=2.241,P<0.05);TVM组术中出血量(100.33±87.04)mL均小于LM(143.31±141.42)、TAM(149.29±132.72)mL(t=2.235,t=2.241,P<0.05);TAM肛门排气时间(46.33±14.89)h均大于LM(38.23±10.22)、TVM(29.51±7.86)h(t=2.275,t=2.341,P<0.05);TAM术后体温恢复正常时间(2.01±1.49)d均大于LM(1.87±1.0)、TVM(1.75±1.62)d(t=2.315,t=2.341,P<0.05);TAM术后住院时间(8.12±1.46)d均大于LM(7.12±1.65)、TVM(6.35±1.27)d(t=2.375,t=2.441,P<0.05)。结论阴式子宫肌瘤剔除术安全、有效、创伤小,术后疼痛轻,并发症少,恢复快,是一种值得推广的微创手术。

Clinical Comparison of Myomectomy by Three Surgical Methods

Objective To compare clinical efficacy and safety of. three kinds vaginal myomectomy. Methods 180 cases of uterine myomectomy according to the different surgical methods were divided into 3 groups： 60 cases with transabdominal myomectomy （TAM）, 60 cases with laparoscopic myomectomy（LM） and 60 cases with transvaginal myemectomy（TVM）, to compare the effects of operation and recovery. Results The operative time（69.58 ± 26.72）min in TVM and （88.93±31.07）min in TAM were less than （115.63±35.12） in LM（t=2.345, t=2.241, P0.05）; The blood loss （100.33 ± 87.04）mL in TAM were less than the（143.31±141.42）mL in LM and （149.29 ± 132.72）mL in TAM （t=2.235, t=2.241, P0.05）; The anal exhaust time （46.33 ±14.89）h in TAM were greater than the（38.23±10.22）h in LM and（29.51±7.86）h in TVM（t=2.275, t=2.341, P0.05）; The time of body temperature returned to normal posto- perative（2.01±1.49）d in TAM were higher than（1.87±1.0）d in LM and（1.75±1.62）d in TVM（t=2.315, t=2.341, P0.05）; The time of hospital stay（8.12 ±1.46）d in TAM were higher than（7.12±1.65）d in LM and（6.35±1.27d in TVM（t=2.375, t=2.441, P0.05）.Conclusion TVM could be performed in selected patients because it shows several advantages：including good safety, less trauma, less pain, quick recovery, low complications.