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目的:探讨比较腹腔镜、阴式和腹式子宫肌瘤剔除术对子宫肌瘤的治疗效果及预后的影响。方法:选取我院自2011年1月至2012年12月收治的130例子宫肌瘤患者作为研究对象进行回顾性调查分析,分别统计其年龄、肌瘤大小和数目、手术时间、术中出血量、术后肠功能恢复时间、术后住院天数和并发症等共八个因素进行分析,并作统计对比,取P<0.05为有统计学意义。结果:手术时间阴式组最短为64.8±14.5 min,腹腔镜组最长为105.8±32.3 min,术中出血量阴式组最少为89.4±21.6 mL,腹式组最多为230.6±45.1 mL,差异有统计学意义(P<0.05)。术后肠胃功能恢复:阴式组为24.6±12.3h,为三组中最短;腹式为33.2±8.9h,为三组中最长。差异具有统计学意义(P<0.05)。术后住院日:腹腔镜组与阴式组术后住院日相近,差异不具有统计学意义(P>0.05),而比腹式术后住院日明显减少,差异具有统计学意义(P<0.05)。术后并发症:腹腔镜组术后并发症为1.40%,少于阴式和腹式,差异具有统计学意义(P<0.05)。结论:阴式子宫肌瘤切除术具有手术时间短、术中出血少、手术恢复快的明显优势,但其对病灶的选择性较大,适合切除下段的肿瘤。腹腔镜子宫肌瘤切除术具有广泛的适用性,并发症少,术后恢复也较快,是值得选择的方式。而腹式手术在各方面都不具有特点,只是在解决高难度的子宫肌瘤上是唯一的选择。
Objective: To compare the effects of laparoscopic, vaginal and abdominal myomectomy on the treatment of uterine fibroids and prognosis. Methods: A total of 130 cases of uterine leiomyoma treated in our hospital from January 2011 to December 2012 were retrospectively analyzed. The age, fibroid size and number, operation time, intraoperative blood loss , Postoperative bowel function recovery time, postoperative hospital days and complications were analyzed, and for statistical comparison, P <0.05 was considered statistically significant. Results: The shortest operative time was 64.8 ± 14.5 min in the vaginal group and 105.8 ± 32.3 min in the laparoscopic group, and the minimum was 89.4 ± 21.6 mL in the vaginal group and 230.6 ± 45.1 mL in the abdominal group. The difference There was statistical significance (P <0.05). Gastrointestinal function recovery after operation: the vaginal group was 24.6 ± 12.3h, which was the shortest among the three groups; the abdomen was 33.2 ± 8.9h, the longest among the three groups. The difference was statistically significant (P <0.05). The postoperative hospitalization days: There was no significant difference in the postoperative hospitalization days between the laparoscopic group and the vaginal group (P> 0.05), while the hospitalization days after the abdominal operation were significantly reduced (P <0.05 ). Postoperative complications: The postoperative complications of laparoscopic group was 1.40%, less than that of vaginal and abdominal, the difference was statistically significant (P <0.05). Conclusion: Vaginal myomectomy has the advantages of short operative time, less intraoperative bleeding and faster recovery of the operation. However, it is more selective for lesion and is suitable for resection of the lower tumor. Laparoscopic myomectomy has a wide range of applicability, fewer complications, postoperative recovery is also faster, is the way to choose. The abdominal surgery in all aspects are not characterized, but difficult to solve difficult uterine fibroids is the only choice.