三种子宫肌瘤剔除术在子宫肌瘤患者中的应用价值比较

目的分析比较开腹子宫肌瘤剔除术、腹腔镜子宫肌瘤剔除术及经阴道子宫肌瘤剔除术的临床疗效。方法选择于2010年3月—2014年1月来我院治疗子宫肌瘤的63例妇女作为研究对象,将其随机分为三组,每组21例,分别采用开腹子宫肌瘤剔除术、腹腔镜子宫肌瘤剔除术及经阴道子宫肌瘤剔除术进行治疗,然后观察对比三组患者的临床疗效。结果三组患者中,腹腔镜子宫肌瘤剔除术的临床有效率最高,为95.2%,开腹式子宫肌瘤剔除术的临床有效率最低为80.9%,阴式子宫肌瘤剔除术的临床有效率为90.4%,腹腔镜和阴式组与开腹式手术方法相比具有显著型差异（P〈0.05）;腹腔镜组和经阴道组在手术术后的排气时间、手术过程中得出血量以及术后住院天数均低于腹式组,具有统计学意义（P〈0.05）,腹腔镜组和经阴道组相比无显著性差异（P〉0.05）;开腹组的手术时间显著短于腹腔镜组和经阴道组（P〈0.05）,而腹腔镜组和经阴道组比较无显著性差异（P〉0.05）;经阴道子宫肌瘤剔除术的复发率最低,显著低于腹腔镜和开腹子宫组,而腹腔镜和开腹子宫组比较无显著性差异。结论三种子宫肌瘤剔除术各有自己的优缺点,腹腔镜和经阴道剔除的创伤小,开腹手术的手术时间短,需要结合患者的疾病状况以及医院的设备条件来选择手术方法。

Clinical analysis of three surgical treatments for uterine fibroids

Objective To investigate and discuss the clinical curative effect of abdominal myomectomy, laparoscopic myomectomy and vaginal myomectomy.Methods We selected 63 cases of women who were treated for uterine fibroids from March 2010 to January 2014 in our hospital as research subjects,and they were randomly divided into three groups, each group has 21 cases,using abdominal myomectomy, laparoscopic myomectomy and vaginal myomectomy for treatment respectively, and then compare the clinical efficacy of the three groups. Results Laparoscopic myomectomy has the highest efficacy, 95.2%,open myomectomy surgery has minimum efficacy,80.9%; the postoperative time,the bleeding volume during surgery and postoperative hospital stay laparoscopic group and vaginal surgery group were lower than open group,and the differences were statistical significant（P〈0. 05）, there was no significant difference when compared the laparoscopic group with vaginal group（P〉0. 05）; the operation time of open surgery group was significantly shorter than the laparoscopic group and the vaginal group（P〈0. 05）, whereas there was no significant difference between the laparoscopic group and the vaginal group（P〉0. 05）;The recurrence rate of the vaginal myomectomy group was significantly lower than the laparoscopic and abdominal hysterectomy group（P〈0. 05）, but there was no significant difference between laparoscopic and abdominal hysterectomy group（P〈0. 05）. Conclusion Each of the three myomectomy surgical treatment has their own advantages and disadvantages, laparoscopic and vaginal myomectomy have small excluding trauma,while open laparotomy has the shortest operation time, it depends on the patients status and the equipment conditions of the hospital to choose the surgical methods.