腹腔镜与经腹子宫肌瘤剔除术的对比分析

目的对比分析腹腔镜下子宫肌瘤剔除术（1aparoscopicmyomectomy，LM）与经腹子宫肌瘤剔除术（tran$-ab—dominaimyomectomy，TAM）的疗效。方法回顾性分析TAM82例患者和同期LM75例患者的临床资料，比较两组患者术中与术后情况。结果腹腔镜组2例中转开腹。开腹组手术时间短于腹腔镜组（P〈0．05）；腹腔镜组术中出血量少于开腹组（P〈0．05）；腹腔镜组术后肛门排气时间及术后住院天数短于开腹组（P〈0．05）；腹腔镜组术后最高体温〉37．8℃者少于开腹组（P〈0．05）；开腹组住院费用明显少于腹腔镜组（P〈0．05）；术后复发率及妊娠率两组无统计学差异（P〉0．05）。结论LM具有切口小、术中出血少、术后恢复快、住院时间短等优点，但需掌握手术适应症，尚不能完全取代开腹手术。

A Comparative Analysis of Laparoscopic and Abdominal Myomectomy

Objective To analyze the curative effects of laparoscopic and open myomectomy. Methods The clinical data of laparoscopic myomectomy（n=75） and abdominal myomectomy （n =82） from January 2008 to January 2010 was analyzed retrospectively.Results Conversions to open surgery were required in 2 cases in the laparoscopic group. The operative time was shor- ter in the open group than in the laparoscopic group （P〈0.05）.The intraoperative haemorrhage volume was less in the laparoscopic group than in the open group （P〈0.05）.Shorter time in the recovery of bowel movement and hospital stay were achieved in the laparoscopic group than in the open group （P〈O.OS）.The persons with postoperative highest temperature 〉37.8C were fewer in the laparoscopic group than in the open group（P=0.012）.The hospitalization cost was significantly less in the open group than in the laparoscopic group （P〈0.05）.There was no sig- nificant difference in the postoperative recurrency and pregnancy rate between the laparoscopic group and the open group（P〉O.05）.Conclusion Though laparoscopic myomectomy has advanta- ges of micro-incision, less bleeding, rapid postoperative recovery and short hospitalization, it cann＇t completely supersede the open myomectomy.