新疆伊犁州哈萨克妇女阴式子宫肌瘤剔除术58例临床分析

目的探讨新疆伊犁州哈萨克民族妇女经阴道子宫肌瘤剔除术的手术方法、可行性及临床效果。方法 2009年10月-2010年10月,新疆伊犁州妇幼保健院对58例哈萨克民族妇女施行经阴道子宫肌瘤剔除术(阴式组),同期哈萨克民族妇女行开腹子宫肌瘤剔除术患者58例(开腹组),比较2组手术效果和术后恢复情况。结果开腹组手术时间、术中出血量、术后肛门排气时间、住院天数分别为(87±20.5)min、(108±23.6)mL、(28±5.9)h、(9.9±1.5)d,阴式组分别为(69±8.3)min,(62±13.7)mL,(23.1±3.5)h,(5.4±1.2)d。2组比较差异具有统计学意义(P<0.05)。阴式组58例患者中,手术均获成功,无中转经腹,其中1例患者术后合并盆腔感染后肠梗阻经治疗后痊愈,开腹组有1例腹部切口愈合不良行二次缝合术。结论新疆哈萨克族妇女体型较为肥胖经阴道子宫肌瘤剔除术具有微创和安全特点,只要术者具备熟练的阴式手术技巧,正确掌握好手术适应证,开展阴式子宫肌瘤剔除术是安全可行的。

Clinical analysis of 58 kazak women with transvaginal myomectomy in Yili Xinjiang

Objective To explore the feasibility and clinical effect of transvaginal myomectomy method in kazak minority women in Yili Xinjiang.Methods A total of 116 kazak minority women with hysteromyomas received myomectomy in Xinjiang YiLi Women and Children Health Care Hospital from October 2009 to October 2010.Clinical data,surgical effect and postoperative recovery of 58 women with transvaginal myomectomy were compared with another 58 women with myomectomy via abdomen.Results For myomectomy via abdomen group,operation time,perioperative bleeding and postoperative flatulence, hospital stay were(87±20.5) min,(108±23.6) mL,(28±5.9) h,and(9.9±1.5) d respectively.For transvaginal myomectomy group were(69±8.3) min,(62±13.7) mL,(23.1±3.5) h,(5.4±1.2) d,respectively.They were statistically significant difference(P<0.05) between two myomectomy methods.Fifty-eight transvaginal myomectomy operations were performed successfully.No case was transferred to open abdominal cavity.Only one patient in transvaginal myomectomy group had pelvic infection and obstruction after operation but recovered completely after treatment.While in myomectomy via abdomen group,one patient who had abdominal incisions infection received the second sutura.Conclusion The somatotypes of kazak women in Xinjiang are prone to obesity.Transvaginal myomectomy is minimally invasive with more safety.As long as the surgeon has skills in transvaginal operation and strictly obeys operation indications,transvaginal myomectomy can be safe and feasible.