探讨阴式子宫肌瘤剥除术的临床地位及术中出血量的影响因素

目的：对阴式子宫肌瘤剥除术的临床应用价值进行评价，并探讨术中出血量的影响因素。方法：回顾性分析2010年3月至2012年10月在我院行经阴道子宫肌瘤剥除术的36例子宫良性肌瘤患者的临床资料，并与行经腹子宫肌瘤剥除术的34例患者的临床资料进行比较。结果：阴式手术组平均手术时间为（61．4＆#177;18．4）min，术中出血量为（74．8＆#177;16．4）mL，术后住院时间为（4．8＆#177;1．4）d，术后病率为2．77％（1/36），术后镇痛使用率为47．22％（17/36），术后肠道功能恢复时间为（23．8＆#177;5．1） h；腹式手术组平均手术时间为（79．4＆#177;22．4）min，术中出血量为（114．5＆#177;18．3）mL，术后住院时间为（7．8＆#177;1．9）d，术后病率为2．94％（1/34），术后镇痛使用率为100％（34/34），术后肠道功能恢复时间为（43．3＆#177;6．2） h，两组在手术时间、术中出血量、术后住院时间、术后镇痛使用率、术后肠道功能恢复时间方面的差异有统计学意义（ P＜0．05）。对阴式手术组术中出血量的影响因素分析发现，单发肌瘤组与多发肌瘤组出血量较少，但差异无统计学意义（ P＞0．05），壁间深部肌瘤组术中出血量明显多于前、后壁肌瘤组，肌瘤直径≥6 cm的患者术中出血量明显多于＜6cm的患者（ P＜0．05）。结论：阴式子宫肌瘤剥除术疗效显著，且创伤小，术中出血量少，住院时间短，术后肠道功能恢复快，值得在临床广泛推广应用，术中出血量的多少主要与子宫肌瘤的生长部位及大小有关。

Clinical Status of Transvaginal Uterine Fibroids Cystectomy ;and the Related Factors of Amount of Blood Loss

Objective：To evaluate the clinical application value of transvaginal uterine fibroids cystecto-my , and explore the factors of the amount of blood loss .Method：The data of 36 cases of uterine fibroids pa-tients underwent transvaginal uterine fibroids cystectomy in our hospital from March 2010 to October 2012 was retrospectively analyzed and compared with 34 cases of cystectomy for abdominal uterine fibroids pa-tients.Result：Vaginal surgery group, the average operation time was （61.4 ＆#177;18.4） min; blood loss was （74.8 ＆#177;16.4） mL;postoperative hospital stay was （4.8 ＆#177;1.4） days; postoperative morbidity rate was 2. 77%（ 1/36）;postoperative analgesic use rate was 47.22%（ 17/36 ）; postoperative intestinal function re-covery time was （23.8 ＆#177;5.1） h.Abdominal surgery group , the average operation time was （ 79.4 ＆#177;22.4） min;blood loss was （114.5 ＆#177;18.3） mL; postoperative hospital stay was （7.8 ＆#177;1.9） days; postoperative morbidity rate was 2.94%（1/34）;postoperative analgesic use rate was 100%（34 /34）;postoperative in-testinal function recovery time was （43.3 ＆#177;6.2） hours;the two groups in operative time , blood loss, postop-erative hospital stay , postoperative analgesic usage , postoperative intestinal function recovery time of differ-ence was statistically significant （P＆lt;0.05）.It found that single group and multiple fibroids group with small amount of bleeding by analysing the blood loss with transvaginal sugery , but the difference was not statistical-ly significant （ P＆gt;0.05） , intramural fibroids deep intraoperative significantly more than the amount of bleed-ing before the posterior wall myoma group , tumor diameter was more than 6cm in patients with blood loss was significantly greater than less than 6cm patients （P＆lt;0.05）.Conclusion： Transvaginal uterine fibroids cys-tectomy has significant effect , with less trauma , less blood loss , shorter hospital stay , faster recovery of bow-el function after surgery , It＆#39;s worth to be widely used in clinical practice .The amount of blood loss mainly connected with growth of uterine fibroids location and size .