宫腔镜与腹腔镜手术治疗子宫肌壁间肌瘤的临床效果比较

目的比较宫腔镜与腹腔镜手术治疗子宫肌壁间肌瘤的临床效果。方法选取我院收治的46例子宫肌壁间肌瘤患者作为研究对象,利用随机数字法将其分为宫腔镜组(23例,宫腔镜手术治疗)和腹腔镜组(23例,腹腔镜手术治疗)。比较两组的临床疗效。结果宫腔镜组的手术时间、下床时间及住院时间均明显短于腹腔镜组,术中出血量明显少于腹腔镜组(P<0.05)。术后1、3、5 d,腹腔镜组的血清TNF-α、IL-6及IL-8水平均明显高于术前,并于术后1、3、5 d逐渐下降(P<0.05);术后1、3 d,宫腔镜组的血清TNF-α、IL-6及IL-8水平明显高于术前,并于术后1、3、5 d逐渐下降(P<0.05);术后1、3、5 d,宫腔镜组的血清TNF-α、IL-6及IL-8水平均明显低于腹腔镜组(P<0.05)。宫腔镜组术后6个月肌层完全愈合率明显高于腹腔镜组,肌层完全愈合时间明显短于腹腔镜组(P<0.05)。两组患者术后并发症总发生率比较,差异无统计学意义(P>0.05)。结论宫腔镜手术治疗子宫肌壁间肌瘤创伤小,对机体造成的炎症损伤小,术后恢复较快,且安全性高,值得临床应用。

Comparison of clinical effects of hysteroscopy and laparoscopy surgery in the treatment of intramural uterine myoma

Objective To compare the clinical effects of hysteroscopy and laparoscopy surgery in the treatment of intramural uterine myoma. Methods A total of 46 patients with intramural uterine myoma admitted in our hospital were selected as the research objects and divided into hysteroscopy group(23 cases, hysteroscopy surgery treatment) and laparoscopy group(23 cases, laparoscopy surgery treatment) according to random number method. The clinical effects of the two groups were compared. Results The operation time, out of bed time and hospitalization time in the hysteroscopy group were significantly shorter than those in the laparoscopy group, and the amount of intraoperative bleeding was significantly less than that in the laparoscopy group(P<0.05). On the 1 st, 3 rd and 5 th day after operation, the levels of serum TNF-α,IL-6 and IL-8 in the laparoscopy group were significantly higher than those before operation, and decreased gradually on the 1 st, 3 rd and 5 th day after operation(P<0.05);on the 1 st and 3 rd day after operation, the levels of serum TNF-α, IL-6 and IL-8 in the hysteroscopy group were significantly higher than those before operation, and decreased gradually on the1 st, 3 rd and 5 th day after operation(P<0.05);on the 1 st, 3 rd and 5 th day after operation, the levels of serum TNF-α, IL-6 and IL-8 in the hysteroscopy group were significantly lower than those in the laparoscopy group(P<0.05). The complete healing rate of myometrium at 6 month after operation in the hysteroscopy group was significantly higher than that in the laparoscopy group, and the complete healing time of myometrium was significantly shorter than that in the laparoscopy group(P<0.05). There was no significant difference in total incidence of postoperative complications between the two groups(P>0.05). Conclusion Hysteroscopic surgery on intramural uterine myoma is less invasive, less inflammatory damage to the body, has faster recovery and high safety, which is worthy of clinical application.