腹腔镜与开腹子宫肌瘤剔除术的临床效果比较分析

目的比较分析腹腔镜与开腹子宫肌瘤剔除术的临床效果。方法2009年1月～2011年1月我院收治的66例子宫肌瘤患者，32例行腹腔镜手术，34例行开腹手术。观察比较：①两组的手术时间、术中出血量及住院时间；②两组的术后镇痛率、切口甲级愈合率。结果两组手术的成功率100％，腹腔镜组无一例中转开腹，两组均无脏器损伤及术后感染等并发症发生。腹腔镜组的手术时间明显长于开腹组。但腹腔镜组的术中出血量明显少于开腹组，术后住院时间明显短于开腹组（P〈0．05）。腹腔镜组术后镇痛率明显低于开腹组（P〈0．05）。腹腔镜组术后切口甲级愈合率略高于开腹组，但两组间比较差异无统计学意义（P〉0．05）。术后随访1～2年，腹腔镜组复发2例，开腹组复发5例，腹腔镜组的复发率明显低于开腹组。结论腹腔镜子宫肌瘤剔除术较开腹手术更具优势，具有创伤小、出血少、恢复快、并发症少等优点，值得广泛推广和应用，但应该注意适应证的选择。

Comparative analysis on clinical effect of laparoscopic and open myomec- tomy surgery

Objective To compare the clinical effect analysis of laparoscopic and abdominal hysterectomy myomecto- my. Methods Among 66 cases of uterine fibroids patients, 32 cases of laparoscopic surgery, 34 cases laparotomy. Ob- served and compared： （1） the operative time, blood loss, and length of stay; （2） postoperative analgesia, incision Grade healing rate. Results The operative time of Laparoscopic group was significantly longer than the laparotomy group, but the laparoscopic group blood loss was significantly less than the open surgery group, postoperative hospital stay was significantly shorter in the laparotomy group （P 〈 0.05）. The laparoscopic group postoperative analgesia was signifi- cantly lower than the open surgery group （P 〈 0.05）. Postoperative incision laparoscopic group Grade healing rate was slightly higher than the open surgery group, but the difference between the two groups was not statistically significant （P 〉0.05）. All patiens followed up for 1-2 years, laparoscopy group relapsed 2 cases,the laparotomy group recur- rence five cases, the recurrence rate was significantly lower than the laparotomy group. Conclusion Laparoscopic my- omectomy surgery than open the advantages surgical trauma, less bleeding, faster recovery, fewer complications, should be popularized and applied, it should be noted indications choice.