子宫肌瘤剔除术的不同手术方法临床效果比较(1)
【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P<0.05)。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
, 百拇医药
【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 (P<0.05). 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.
, 百拇医药
【Key words】 Abdominal； Laparoscope； Uterine fibroids rejecting operation； Analysis
First-author’s address： Xingcheng People’s Hospital of Liaoning Province， Xingcheng 125100， China
doi：10.3969/j.issn.1674-4985.2015.01.026
子宫肌瘤是育龄期妇女生殖器官最常见的良性肿瘤，发病率达20%～30%[1]，临床表现为月经失调、腹痛、尿频、不孕等，严重影响女性的生活质量。近年来，随着妇女自身保健意识的增强和健康体检的普及，其发病率似有增加的趋势，且子宫的生理功能和机体器官的完整性逐渐受到重视，使得子宫肌瘤剔除术也日益增加[2]。而随着妇科腹腔镜技术不断提高，腹腔镜下子宫肌瘤剔除术成为手术医生和患者的首选。一些特殊部位的子宫肌瘤在腹腔镜下剔除有一定的困难和风险，传统观点认为选择开腹手术为宜，因此两种手术方法在治疗上各有优劣。本次研究选择对象共98例，均为近3年在本院行以上两种手术方式的患者，对其临床资料进行回顾性分析，现将详细情况报告如下。
1 资料与方法
1.1 一般资料 收集2012年1月-2014年5月在本院进行子宫肌瘤剔除术患者98例，单发肌瘤，肌瘤直径6～12 cm为纳入对象。根据患者手术方式分为两组，LM组：腹腔镜下子宫肌瘤剔除术67例(其中包括肌壁间肌瘤31例，浆膜下肌瘤20例，阔韧带肌瘤5例，峡部肌瘤3例，宫角部肌瘤4例，宫颈肌瘤, 百拇医药(郭萍 李玲)
【关键词】 经腹； 腹腔镜； 子宫肌瘤剔除术； 分析
, 百拇医药
【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 (P<0.05). 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.
, 百拇医药
【Key words】 Abdominal； Laparoscope； Uterine fibroids rejecting operation； Analysis
First-author’s address： Xingcheng People’s Hospital of Liaoning Province， Xingcheng 125100， China
doi：10.3969/j.issn.1674-4985.2015.01.026
子宫肌瘤是育龄期妇女生殖器官最常见的良性肿瘤，发病率达20%～30%[1]，临床表现为月经失调、腹痛、尿频、不孕等，严重影响女性的生活质量。近年来，随着妇女自身保健意识的增强和健康体检的普及，其发病率似有增加的趋势，且子宫的生理功能和机体器官的完整性逐渐受到重视，使得子宫肌瘤剔除术也日益增加[2]。而随着妇科腹腔镜技术不断提高，腹腔镜下子宫肌瘤剔除术成为手术医生和患者的首选。一些特殊部位的子宫肌瘤在腹腔镜下剔除有一定的困难和风险，传统观点认为选择开腹手术为宜，因此两种手术方法在治疗上各有优劣。本次研究选择对象共98例，均为近3年在本院行以上两种手术方式的患者，对其临床资料进行回顾性分析，现将详细情况报告如下。
1 资料与方法
1.1 一般资料 收集2012年1月-2014年5月在本院进行子宫肌瘤剔除术患者98例，单发肌瘤，肌瘤直径6～12 cm为纳入对象。根据患者手术方式分为两组，LM组：腹腔镜下子宫肌瘤剔除术67例(其中包括肌壁间肌瘤31例，浆膜下肌瘤20例，阔韧带肌瘤5例，峡部肌瘤3例，宫角部肌瘤4例，宫颈肌瘤, 百拇医药(郭萍 李玲)