腹腔鏡下袋式子宮肌瘤切除術的54例分析

陳崢崢等

[摘要] 目的 探討腹腔鏡下袋式子宮肌瘤切除治療多發(fā)性子宮肌瘤的臨床效果及可行性。方法 腹腔鏡組為54例多發(fā)性子宮肌瘤患者行腹腔鏡袋式子宮肌瘤切除術，對照組為54例患者行經(jīng)腹多發(fā)性子宮肌瘤切除，觀察兩組手術時間、術中出血量、術后排氣時間、術后住院天數(shù)等情況。 結果 所有病例手術均獲成功，無一例中轉開腹，無手術并發(fā)癥發(fā)生。腹腔鏡組平均手術時間（118.35±2.98）min，術中出血（96.06±1.86）mL，術后排氣時間（22.13±0.53）h ，術后住院天數(shù)（4.17±0.15）d。腹腔鏡組術中出血少、術后腸功能恢復快、住院天數(shù)短，與開腹組比較差異有統(tǒng)計學意義（P<0.05）。 結論 腹腔鏡下袋式子宮肌瘤切除術是安全、可行的，擴大了腹腔鏡子宮肌瘤切除術的手術指征。

[關鍵詞] 腹腔鏡；子宮肌瘤剔除術；子宮平滑肌瘤

[中圖分類號] R4 [文獻標識碼] A [文章編號] 1674-0742（2015）04（c）-0047-03

[Abstract] Objective To investigate the feasibility of laparoscopic bag hysteromyoma resection. Methods Fifty-four patients with multiple uterine myomas undergoing laparoscopic myomectomy were analyzed. The patients were divided into two groups according to the surgical pathway， LM （1aparoscopic myomectomy） group and OM（open myomectomy） group. The clinical features such as the average operating time， blood loss， postoperative exhaust time and average time of hospital stay were compared among the two groups. Results All cases were performed successfully laparoscopically. No intra-operative laparotomy or complications occurred. The average operating time were （118.35±2.98）min and blood loss were （96.06±1.86）mL. The postoperative exhaust time and average time of hospital stay was （22.13±0.53）min and （4.17±0.15）d. The blood loss， postoperative exhaust time and average time of hospital stay in LM group were significantly less than those in OM group （P<0.05）. Conclusions Laparoscopic bag hysteromyoma resection can be performed and the operation indication is enlarged.

[Key words] Laparoscopy； Myomectomy； Uterine fibroids

隨著腹腔鏡技術的不斷提高及手術經(jīng)驗的積累，腹腔鏡下子宮肌瘤剔除術逐漸成熟并廣泛應用，但多發(fā)性子宮肌瘤因為手術操作時間長，瘤腔縫合止血困難，常常被列為腹腔鏡手術的禁忌。為了滿足多發(fā)性子宮肌瘤患者的微創(chuàng)要求，該研究對2012年1月—2013 年12月間該院疏浚的54例多發(fā)性子宮肌瘤患者進行腹腔鏡袋式子宮肌瘤切除術，取得了滿意的效果，現(xiàn)報道如下。

1 資料與方法

1.1 一般資料

隨機選擇2012年1月—2013 年12月在安徽省立醫(yī)院婦產(chǎn)科因多發(fā)性子宮肌瘤需行腹腔鏡子宮肌瘤切除術的患者54例，年齡（35.1±0.8）歲，肌瘤最大直徑3～6 cm。分為腹腔鏡袋式子宮肌瘤切除組（腹腔鏡組）和經(jīng)腹子宮肌瘤切除組（經(jīng)腹組）各54例。兩組年齡、子宮大小及肌瘤數(shù)目等方面比較差異無統(tǒng)計學意義（P > 0.05）。所……