子宫肌瘤剔除术不同手术方法临床效果比较.doc

子宫肌瘤剔除术不同手术方法临床效果比较 　　【摘要】 目的：比较经腹子宫肌瘤剔除术（TAM）和腹腔镜子宫剔除术（LM）的临床效果和特点。方法：回顾性分析2012年1月-2014年5月在本院行经腹或腹腔镜子宫肌瘤剔除术的98例患者临床资料，按手术形式分为TAM组和LM组，其中LM组67例，TAM组31例。对比分析两组患者的手术时间、手术中出血量、住院日期以及术后恢复情况。结果：两组手术均获成功，术中无一例发生周围邻近器官损伤。观察组手术时间、术中出血量、肛门排气时间、术后住院日及术后病率依次为（113±13.7）min、（99±11.9）mL、（33.4±6.3）h、（5.3±0.8）d、8.9%；对照组分别为（83±7.2）min、（124±15）mL、（54±9.6）h、（7.2±0.6）d、25.8%，两组比较，差异均有统计学意义P0.05）。结论：TAM适应证较为广泛，不受肌瘤部位和大小限制；LM手术出血少、术后恢复快、创伤小，具体操作中，可根据手术技巧及操作步骤应该灵活掌握，扩大腹腔镜下子宫肌瘤剔除术的适应证。 　　【关键词】 经腹； 腹腔镜； 子宫肌瘤剔除术； 分析 　　【Abstract】 Objective： To compare the clinical efficacy and characteristics between transabdominal myomectomy（TAM） and laparoscopic myomectomy（LM）. Method： The clinical data of 98 patients who performed TAM or LM from January 2012 to May 2014 were retrospectively analyzed. According to the operation modes， patients were divided into TAM group （n=67） and LM group （n=31）. Comparison and analysis of operation duration， intra-operative blood loss， hospitalization period and postoperative recovery between the two groups were performed. Result： Operations were all succeed in both groups and no adjacent organ injury happened. The operation duration， intral-operative blood loss， anus exhausting time， postoperative hospitalization period and postoperative morbidity of the observation group was （113±13.7）min， （99±11.9）mL， （33.4±6.3）h， （5.3±0.8）d and 8.9% respectively， and （83±7.2）min， （124±15）mL， （54±9.6）h， （7.2±0.6）d and 25.8% for the control group. The differences were statistically significant （P0.05）. Conclusion： TAM carries a wider scope of indications without being limited by the site and size of fibroid； while LM holds characteristics of less intra-operative blood loss， speedy post-operative and smaller injury. For specific operations， surgical techniques and operation procedures can be adopted flexibly to extend the scope of LM indications. 　　【Key words】 Abdominal； Laparoscope； Uterine fibroids rejecting operation； Analysis 　　First-author’s address： Xingcheng People’s Hospit