经阴道子宫肌瘤剔除术临床效果评价

目的评价经阴道子宫肌瘤剔除术的临床效果，探讨手术病例的恰当选择，达到微创治疗目的。方法对2000年8月～2011年8月本院收治的子宫肌瘤剔除患者的临床资料进行回顾性分析。经阴道子宫肌瘤剔除术为研究组，共685例：腹腔镜子宫肌瘤剔除术为对照组，共742例；观察两组的年龄、经产妇比例、盆腔手术史、临床症状、肌瘤个数、最大肌瘤的位置、手术时间、术中出血量、术中副损伤、合并其他手术、术后血红蛋白的下降、术后肛门排气时间、住院时间等指标。结果研究组和对照组在年龄、临床症状、盆腔手术史方面差异无统计学意义，经产妇比例和肌瘤个数的差异有统计学意义。研究组最大肌瘤位置位于浆膜下、后壁、子宫下部的比例高于对照组，差异有统计学意义：研究组最大肌瘤位置位于肌壁间、前壁、近宫底部的比例低于对照组，差异有统计学意义。研究组手术时间、出血量、术后排气时间、术后血红蛋白下降值、术后排气时间均低于对照组，差异有统计学意义。两组发生副损伤、合并其他手术、术后病率方面差异无统计学意义。研究组住院时间较对照组长，差异有统计学意义。结论经阴道子宫肌瘤剔除术手术时间短、出血少、并发症少、恢复快，临床效果好，手术成功的关键在于最大肌瘤的位置。

Clinical effect evaluation of hysteromyomectomy by vagina

Objective To evaluate the clinical effectiveness of hysteromyomectomy by vagina and to investigate appropriate operative method for minimally invasive treatment.Methods The uterine myomectomy eliminate patients the clinical data from August 2000 to August 2011 were retrospectively analyzed.The hysteromyomectomy vagina as the research group,a total of 685 patients;Laparoscopic myomectomy as the control group,a total of 742 patients;The two groups of age,the proportion of women,pelvic surgery history,clinical symptoms,fibroids number,the location of the maximum fibroids,operation time,peri-operative bleeding,intraoperative vice injury,with other surgery,postoperative hemoglobin decline,postoperative anal exhaust time,the length of time the index were observe.Results There was no statistical significance in age,the clinical symptoms,pelvic surgery,no statistically significant differences,the proportion of women and fibroids number between the two groups;The maximum fibroids position subserosal,wall,the lower part of the uterus after proportion in research group were higher than those in the control group,the difference was statistically significant;The maximum fibroids position intramural,former wall,near the bottom of the palace ratio in research group were lower than those of the control group,the difference was statistically significant;The operation time,the bleeding and postoperative exhaust time,postoperative hemoglobin drop value,postoperative exhaust time in the research group were lower than those of the control group,the difference was statistically significant;The vice injury,with other happened after surgery,disease rate difference was statistically significant between the two groups.The team was the length of time than the control group,the difference was statistically significant.Conclusion Vaginal myomectomy has good efficacy with short operating time,less complications,less bleeding,quick recovery.The most important thing for successful operation is to control the position of the largest myomas.