子宫肌瘤剔除术手术效果比较分析

目的：评价腹式、阴式和腹腔镜下子宫肌瘤剔除术的临床资料，比较分析其优缺点。方法：回顾分析腹式子宫肌瘤剔除术102例（腹式组）、阴式子宫肌瘤剔除术65例（阴式组）和腹腔镜下子宫肌瘤剔除术68例（腹腔镜组）的临床资料，比较各组手术时间、术中失血量、单个肌瘤重量、排气时间、术后病率及住院时间。结果：腹腔镜组手术时间（112．1±37．3）min高于腹式组（96．3±32．8）min和阴式组（56．7±20．0）min；腹腔镜组术中失血量（95．7±31．8）ml高于阴式组（59．5±21．0）ml，低于腹式组（119．2±40．6）ml；腹腔镜组剔除肌瘤单个平均重量（77．4±25．8）g显著低于腹式组（124．7±42．5）g，高于阴式组（68．6±24．2）g。腹腔镜组术后住院时间（4．7±1．0）d显著少于腹式组（7．5±1．6）d和阴式组（6．5±1．5）d.各组术后并发症发生及复发率差异无显著性。结论：腹腔镜子宫肌瘤剔除术及阴式子宫肌瘤剔除术均具有损伤小、恢复快的优点，腹式子宫肌瘤剔除术具有手术适应证广的优点.

Comparative analysis of effect of uterine myomectomy surgery

Objective ：To evaluate the clinical data of 235 cases of abdominal, vaginal and laparoscopic myomectomy,and to compare the advantages and disadvantages. Methods：Retrospective clinical analysis of abdominal myomectomy of 102 cases（abdominal group）, vaginal myomectomy of 65 cases（vaginal group） and laparoscopic myomectomy of 68 cases（laparoscopic group） was performed.The operative time,intraoperative blood loss,weight of a single fibroid, exhaust time,postoperative morbidity and length of stay in hospital of each group were compared. Results ：The operative time of laparoscopic surgery group （112.1±37.3 min） were longer than the abdominal group （96.3±32.8min） and vaginal group （56.7±20.0min）. The intraoperative blood loss of laparoscopic group （95.7±31.8ml） was higher than the vaginal group （59.5±21.0ml）,but less than the abdominal group （119.2±40.6ml）. The weight of a single fibroid of laparoscopic group （77.4±25.8g） was significantly lower than the abdominal group （124.7±42.5）g,higher than the vaginal group （68.6±24.2）g. Length of stay in hospital of laparoscopic group （4.7±1.0）d was significantly less than the abdominal group （7.5±1.6）d） and vaginal group （6.5±1.5）d. Postoperative complications in each group and the relapse rate had no significant difference. Conclusion：Laparescopic myomectomy and vaginal myomectomy have the advantages of small injury and quick recovery. Abdominal myomectomy has the advantage of broad indication.