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目的比较腹腔镜下子宫肌瘤切除术(laparoscopic hysteromyomectomia,LM)、经阴道子宫肌瘤切除术(transvaginal hysteromyomectomia,TVM)和开腹子宫肌瘤切除术(abdominal hysteromyomectomia,TAM)三种术式的临床效果。方法选择2006年7月至2007年7月入住天津市中心妇产科医院需手术治疗切除子宫肌瘤的150例患者,分为3组:LM组54例,TVM组46例,TAM组50例,对3组围手术期的手术时间、术中出血量、术后病率、术后住院天数等情况进行比较。结果3组手术时间、术中出血量、术后病率和术后住院天数差异均有统计学意义(P<0.05),TVM组手术时间、术中出血量和术后住院天数皆最短,TAM组术后病发生率高于TVM和LM组,差异均有统计学意义(P<0.05)。结论三种术式各有优劣,LM和TVM具有创伤小、术中出血少、术后恢复快、术后住院天数短等优点,但不能完全替代TAM,对于较困难的子宫肌瘤切除术,TAM仍为最佳选择。
Objective To compare laparoscopic hysteromyomectomia (LM), transvaginal hysteromyomectomia (TVM) and abdominal hysteromyomectomia (TAM) effect. Methods From July 2006 to July 2007, 150 patients who underwent surgical resection of uterine fibroids in Tianjin Obstetrics and Gynecology Hospital were divided into three groups: 54 cases in LM group, 46 cases in TVM group and 50 cases in TAM group The operation time, intraoperative blood loss, postoperative morbidity and postoperative hospital stay were compared between the three groups. Results The operation time, intraoperative blood loss, postoperative morbidity and length of postoperative hospital stay were all significantly different among the three groups (P <0.05). The TVM group had the shortest operation time, intraoperative blood loss and postoperative hospital stay, while TAM The incidence of postoperative disease was higher in TVM and LM groups (P <0.05). Conclusion The three kinds of surgical procedures have their own advantages and disadvantages. LM and TVM have the advantages of less trauma, less intraoperative bleeding, faster postoperative recovery and shorter postoperative hospital stay, but they can not completely replace TAM. For more difficult myomectomy , TAM is still the best choice.