小切口开腹与腹腔镜下子宫肌瘤剔除术的临床结局分析
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[摘要] 目的 比较分析小切口开腹与腹腔镜下子宫肌瘤剔除术治疗子宫肌瘤患者的临床疗效，探讨其应用价值。 方法 将2009年10月～2011年6月在我院进行治疗的76例子宫肌瘤患者随机分为两组，对照组（n = 38）患者采用小切口开腹手术进行治疗，观察组（n = 38）患者采用腹腔镜下子宫肌瘤剔除术进行治疗，观察两组的临床疗效，对两组患者的术中出血量、术后排气时间、术后住院天数、并发症及复发率等进行比较。 结果 观察组患者的术中出血量、术后排气时间、住院天数及术后复发率情况均少于对照组患者，两组比较，差异有统计学意义（P < 0.05）。 结论 对子宫肌瘤患者采用腹腔镜下子宫肌瘤剔除术进行治疗，不仅能够减少患者的出血量，缩短住院时间，同时可以减少术后复发率，其疗效显著，具有很好的临床应用价值。
[关键词] 子宫肌瘤；腹腔镜下子宫肌瘤剔除术；小切口开腹
[中图分类号] R737.33 [文献标识码] A [文章编号] 1673-7210（2012）08（a）-0067-02
Analysis of clinical outcomes of minilaparotomy and laparoscopic myomectomy surgery
CHU Hua
Women and Children Hospital of Heping Area in Shenyang City, Liaoning Province, Shenyang 110005, China
[Abstract] Objective To compare and analyze the clinical efficacy of treatment of minilaparotomy and laparoscopic myomectomy in patients with uterine myoma, and to explore its value of applications. Methods 76 cases of patients with uterine fibroids treated in our hospital from October 2009 to June 2011, were randomly divided into two groups, control group (n = 38): with minilaparotomy surgical treatment, the observation group (n = 38): with laparoscopic myomectomy surgery treatment, then the clinical efficacy of the two groups were observed, the intraoperative blood loss, postoperative flatus, postoperative length of hospital stay, complications, and relapse rates of patients of the two groups were compared. Results The intraoperative blood loss, postoperative flatus, hospital stay and recurrence rate of observation group patients were less than those of control group, there were significant differences between the two groups (P < 0.05). Conclusion For patients with uterine fibroids, treatment with laparoscopic myomectomy surgery can not only reduce the amount of bleeding, shorter hospital stay but also reduce the recurrence rate, its effect is significant, with a good clinical application value.
[Key words] Uterine fibroids; Laparoscopic myomectomy; Minilaparotomy
子宫肌瘤也称为子宫平滑肌瘤，是发生在女性生殖器常见的一种良性肿瘤，其患者多无临床症状，少数患者可出现阴道出血和压迫症状等[1]，临床上之前主要采取子宫切除术进行治疗，但是近年来由于很多女性要求在手术过程中不仅要保留生育功能，同时保证子宫的生理功能，因此，子宫剔除术的应用越来越普遍。本文主要比较小切口开腹与腹腔镜下子宫肌瘤剔除术对于子宫肌瘤患者治疗的临床疗效，评价其临床应用价值。
1 资料与方法
1.1 一般资料
本次研究对象主要为于2009年10月～2011年6月在我院治疗的76例子宫肌瘤患者，所有患者均经过B超或宫颈细胞学的检查进行确诊，对具有子宫颈和内膜恶性病变的患者及手术禁忌证的患者进行排除。将所有患者随机分为观察组（n = 38）和对照组（n = 38）。观察组患者年龄24～42岁，平均31.7岁；已婚34例，未婚4例，已生育的患者31例；肌瘤直径2～7 cm，平均4.7 cm；25例患者为肌壁间肌瘤患者，13例患者为浆膜下肌瘤。对照组患者年龄23～45岁，平均34.2岁；已婚患者33例，未婚患者5例，已生育的患者30例；肌瘤直径3～8 cm，平均5.1 cm；26例患者为肌壁间肌瘤，12例患者为浆膜下肌瘤。两组患者在年龄、肌瘤大小及疾病类型方面基本一致，差异无统计学意义（P ＞ 0.05），具有可比性。