经阴道与经腹腔镜行子宫肌瘤剔除术的临床分析

目的比较分析经阴道与经腹腔镜行子宫肌瘤剔除术的临床效果。方法选取扬州友好医院行手术治疗的子宫肌瘤患者96例,其中观察组46例行经阴道子宫肌瘤剔除术,对照组50例行经腹腔镜子宫肌瘤剔除术,观察两组患者术中情况、住院花费、术后情况、肌瘤复发率及肌瘤残留率。结果两组患者手术时间、术中出血量、住院时间、术后病率及镇痛剂使用率方面比较,差异无统计学意义(P0.05);观察组剔除的肌瘤数多于对照组(P0.05),观察组住院费用、肛门排气时间少于对照组(P0.05);两组子宫肌瘤复发率、残留率比较,差异无统计学意义(P0.05)。结论经阴道子宫肌瘤剔除术剔除的肌瘤数多,而经腹腔镜子宫肌瘤剔除术手术创伤小,粘连发生率低。两种手术方式的选择应根据患者的需求、子宫肌瘤的数目、大小及手术者的经验来选择合适的手术方式。

The clinical analysis of vaginal myomectomy and laparoscopic myomectomy

Objective To analyze the clinical efficacy of vaginal myomectomy and laparoscopic myomectomy. Methods 96 cases with uterine leiomyoma in Friendship Hospital of Yangzhou from October 2010 to January 2014 were enrolled, 46 patients conducted vaginal myomectomy were selected as the observation group, 50 patients conducted laparoseopic myomeetomy were selected as the control group. The intraoperative situation, hospitalization cost, postoperative situation, uterine leiomyoma relapse rate and the rate of myoma residual in the two groups were observed. Results No significant difference were found in operation time, length of stay, postoperative morbidity, the amount of bleeding and analgesic use rate between the two groups （ P 〉 0. 05 ）. The number of myoma in the observation group was more than the control group （ P 〈 0. 05 ）. The hospitalization expenses and postoperative exhaust time in the observation group were less than the control group （ P 〈 0. 05 ）. No significant difference were found in uterine leiomyoma relapse rate and the rate of myoma residual （P 〉 0. 05 ）. Conclusion Vaginal myomectomy has characteristics of more removing myoma, while laparoscopic myomectomy has characteristics of little operation trauma, low incidence of adhesions. Appropriate operation mode should be chosen according to the requirement of patients, number and size of uterine leiomyoma, operation experience of doctor.