辽西地区腹腔镜下巨大子宫肌瘤原位旋切核除术的临床实践

目的探讨腹腔镜下原位旋切法核除巨大子宫肌瘤的临床价值。方法回顾性分析该院2010—2013年开展的巨大子宫肌瘤腹腔镜手术45例,其中原位旋切法核除肌瘤22例（研究组）,子宫肌瘤传统核除术23例（对照组）,分析比较两组的子宫切口大小、手术时程、术中出血量、术后排气排尿时间、总住院时间及术后并发症。结果 45例手术均顺利完成,数据显示研究组子宫切口（6.31±2.01）cm小于对照组（9.01±1.91）cm,手术时间（50.38±11.65）min短于对照组（90.56±10.78）min,术中出血量（48.65±20.43）m L少于对照组（100.7±34.21）m L,组间差异有统计学意义（P〈0.05）。研究组与对照组关于术后排气时间、术后排尿时间和总住院时间,组间差异无统计学意义（P〉0.05）。结论对于巨大子宫肌瘤,腹腔镜下原位旋切核除术可以与传统术式比肩,正在接受临床实践的进一步检验。

A Clinical Experience About In-situ Rotary Cutting Myomectomy of Giant Hysteromyoma with Laparoscope in West Liaoning Region

Objective To explore the clinical value bout in-situ rotary cutting myomectomy of giant hysteromyoma with laparoscope.Methods 45 cases with giant hysteromyoma underwent laparoscopic surgery in our hospital from 2010 to 2013 were analyzed retrospectively.22 cases in the research group were treated by in-situ rotary cutting myomectomy,and 23 cases in the control group were treated by traditional myomectomy.The length of uterus incision,surgery duration,intraoperative blood loss,postoperative exhaust time and urination time,the total hospital stay time,and postoperative complications were compared and analyzed between the two groups.Results The surgeries of the 45 cases were performed smoothly.The data showed that in the research group,the length of uterus incision was（6.31±2.01）cm,shorter than the control group＇s（9.01±1.91）cm,surgery duration was（50.38±11.65）min,shorter than the control group＇s（90.56 ±10.78）min,and intraoperative blood loss was（48.65 ±20.43）m L,less than the control group＇s（100.7±34.21）m L,the differences between the two groups were statistically significant（P〈0.05）.The differences in postoperative exhaust time and urination time,total hospital stay time between the two groups were not statistically signifi-cant（P〉0.05）.Conclusion For giant hysteromyoma,in-situ rotary cutting myomectomy with laparoscope and traditional myomectomy,they are neck and neck with each other at least.The improved procedure is undergoing further tests of clinical practice.