腹腔镜子宫肌瘤剔除术与开腹手术治疗子宫肌瘤的临床效果比较(1)
[摘要]目的 探讨微创腹腔镜子宫肌瘤剔除术与传统开腹手术治疗子宫肌瘤的临床疗效。方法 选择我院2014年2月～2015年6月收治的子宫肌瘤患者70例作为研究对象，将其随机分成研究组和对照组各35例，对照组采用传统开腹手术治疗子宫肌瘤，研究组采用微创腹腔镜子宫肌瘤剔除术。观察两组的手术时间、排气时间、术后住院时间、术中出血量、月经周期与持续天数。结果 研究组的手术时间、排气时间以及术后住院时间均明显短于对照组(P<0.05)；术中出血量明显少于对照组，差异有统计学意义(P<0.05)。随访3个月，研究组的月经周期与持续天数与对照组差异无统计学意义(P>0.05)。结论 腹腔镜子宫肌瘤剔除术是治疗子宫肌瘤理想的微创手术方法，具有术后恢复快、术后用药少、住院时间短、切口外观整洁等较多优点，值得临床推广应用。
[关键词]子宫肌瘤；腹腔镜；子宫肌瘤剔除术；开腹术
[中图分类号]R713.4 [文献标识码]A [文章编号]1674-4721(2016)06(a)-0104-03
[Abstract]Objective To explore the clinical effect of laparoscopic hysteromyomectomy and laparotomy in the treatment of myoma of uterus.Methods From February 2014 to June 2015，70 patients with myoma of uterus admitted into our hospital were selected as research objects and evenly divided into research group and control group.In the control group，traditional laparotomy was used，while in the research group laparoscopic hysteromyomectomy was adopted.Operation time，exhaust time，postoperative hospital stays，the amount of bleeding during surgery，menstrual cycle and duration were observated.Results Operation time，exhaust time，and postoperative hospital stays in the research group was greatly shorter than that in the control group respectively (P<0.05).The amount of bleeding during surgery was lower than that in the control group with statistical differences (P<0.05).After 3-month follow up visits，menstrual cycle and duration was not greatly different in comparison with that in the control group (P>0.05).Conclusion Laparoscopic hysteromyomectomy is an ideal minimal-invasive surgical method on treating myoma of uterus with advantages of quick recovery after surgery，few medication after surgery，short hospital stays，and clean and tidy appearance of incision，which is worthy of extensive promotion and application in clinic.
[Key words]Myoma of uterus；Laparoscope；Laparoscopic hysteromyomectomy；Laparotomy
子宫肌瘤以40～50岁妇女较为多见，是妇科疾病中最常见的良性肿瘤，发生率为20%～30%，其病理机制为子宫平滑肌细胞过度增生。目前对于子宫肌瘤的治疗仍以介入性治疗为主。传统开腹手术操作存在诸多缺点，如创口较大、出血量多、恢复慢、预后瘢痕大并且可发生粘连、疼痛等并发症，因此子宫肌瘤剔除术也逐渐由传统开腹向微创腹腔镜技术发展。
1资料与方法
1.1一般资料
选择我院2014年2月～2015年6月收治的子宫肌瘤患者70例作为研究对象，将其随机分成研究组和对照组各35例，所有患者均符合《子宫肌瘤诊断标准》[1]，患者存在以下临床症状：子宫出血，诉有下腹坠胀感、腰背酸痛、白带增多，并经超声检查、宫腔镜检查和腹腔镜检查确诊。参与本次研究的患者均排除严重心、肝、肾、肺疾病。两组患者的子宫肌瘤病变特点、部位、程度(按轻中重分级)以及持续时间等差异均无统计学意义(P>0.05)。研究组患者平均年龄为(36.4±3.8)岁，子宫肌瘤平均大小为(5.4±1.7)cm，与对照组的(37.1±3.7)岁和(6.7±2.1)cm相比，差异无统计学意义(P>0.05)。
1.2方法
①对照组：患者采用仰卧位，进行全身麻醉或腹膜外麻醉。常规开腹，切口位置可选择为下腹正中纵向切口或耻骨联合上方横切口，进入腹腔后可在肌瘤突出位置切开子宫浆肌层，剔除子宫肌瘤后缝合肌层残端。, 百拇医药(陈卫东)
[关键词]子宫肌瘤；腹腔镜；子宫肌瘤剔除术；开腹术
[中图分类号]R713.4 [文献标识码]A [文章编号]1674-4721(2016)06(a)-0104-03
[Abstract]Objective To explore the clinical effect of laparoscopic hysteromyomectomy and laparotomy in the treatment of myoma of uterus.Methods From February 2014 to June 2015，70 patients with myoma of uterus admitted into our hospital were selected as research objects and evenly divided into research group and control group.In the control group，traditional laparotomy was used，while in the research group laparoscopic hysteromyomectomy was adopted.Operation time，exhaust time，postoperative hospital stays，the amount of bleeding during surgery，menstrual cycle and duration were observated.Results Operation time，exhaust time，and postoperative hospital stays in the research group was greatly shorter than that in the control group respectively (P<0.05).The amount of bleeding during surgery was lower than that in the control group with statistical differences (P<0.05).After 3-month follow up visits，menstrual cycle and duration was not greatly different in comparison with that in the control group (P>0.05).Conclusion Laparoscopic hysteromyomectomy is an ideal minimal-invasive surgical method on treating myoma of uterus with advantages of quick recovery after surgery，few medication after surgery，short hospital stays，and clean and tidy appearance of incision，which is worthy of extensive promotion and application in clinic.
[Key words]Myoma of uterus；Laparoscope；Laparoscopic hysteromyomectomy；Laparotomy
子宫肌瘤以40～50岁妇女较为多见，是妇科疾病中最常见的良性肿瘤，发生率为20%～30%，其病理机制为子宫平滑肌细胞过度增生。目前对于子宫肌瘤的治疗仍以介入性治疗为主。传统开腹手术操作存在诸多缺点，如创口较大、出血量多、恢复慢、预后瘢痕大并且可发生粘连、疼痛等并发症，因此子宫肌瘤剔除术也逐渐由传统开腹向微创腹腔镜技术发展。
1资料与方法
1.1一般资料
选择我院2014年2月～2015年6月收治的子宫肌瘤患者70例作为研究对象，将其随机分成研究组和对照组各35例，所有患者均符合《子宫肌瘤诊断标准》[1]，患者存在以下临床症状：子宫出血，诉有下腹坠胀感、腰背酸痛、白带增多，并经超声检查、宫腔镜检查和腹腔镜检查确诊。参与本次研究的患者均排除严重心、肝、肾、肺疾病。两组患者的子宫肌瘤病变特点、部位、程度(按轻中重分级)以及持续时间等差异均无统计学意义(P>0.05)。研究组患者平均年龄为(36.4±3.8)岁，子宫肌瘤平均大小为(5.4±1.7)cm，与对照组的(37.1±3.7)岁和(6.7±2.1)cm相比，差异无统计学意义(P>0.05)。
1.2方法
①对照组：患者采用仰卧位，进行全身麻醉或腹膜外麻醉。常规开腹，切口位置可选择为下腹正中纵向切口或耻骨联合上方横切口，进入腹腔后可在肌瘤突出位置切开子宫浆肌层，剔除子宫肌瘤后缝合肌层残端。, 百拇医药(陈卫东)