腹腔鏡與開腹子宮肌瘤剔除術(shù)治療子宮肌瘤的臨床效果比較

吳名桃

[摘要]目的 比較腹腔鏡與開腹子宮肌瘤剔除術(shù)治療子宮肌瘤的臨床效果。方法 選取2016年6月～2018年9月我院收治的150例子宮肌瘤患者作為研究對(duì)象，采用隨機(jī)摸球法將其分為對(duì)照組（n=100）和觀察組（n=50）。對(duì)照組患者采用開腹子宮肌瘤剔除治療，觀察組患者主要進(jìn)行腹腔鏡子宮肌瘤剔除治療。比較兩組患者的出血量、排氣時(shí)間、住院時(shí)間、手術(shù)時(shí)間及術(shù)后并發(fā)癥發(fā)生情況。結(jié)果 觀察組患者的術(shù)中出血量少于對(duì)照組，手術(shù)時(shí)間長于對(duì)照組，住院時(shí)間以及術(shù)后排氣時(shí)間短于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（t=123.518、9.980、16.568、5.732，P<0.05）。觀察組患者的并發(fā)癥總發(fā)生率為2.00%（1/50），低于對(duì)照組的7.00%（7/100），差異有統(tǒng)計(jì)學(xué)意義（χ2=8.510，P<0.05）。兩組患者的子宮肌瘤復(fù)發(fā)率、子宮異常率以及癥狀緩解率比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。結(jié)論 進(jìn)行腹腔鏡子宮肌瘤剔除治療時(shí)，可有效縮短患者的住院時(shí)間，減少術(shù)中出血量，控制并發(fā)癥，治療效果顯著，有臨床應(yīng)用價(jià)值。

[關(guān)鍵詞]腹腔鏡;開腹子宮肌瘤剔除術(shù);子宮肌瘤;臨床效果

[中圖分類號(hào)] R271.7 ? ? [文獻(xiàn)標(biāo)識(shí)碼] A ? ? [文章編號(hào)] 1674-4721（2019）11（b）-0110-03

Clinical effect comparison of laparoscopic and laparotomic hysteromyomectomy in the treatment of uterine fibroids

WU Ming-tao

Department of Gynecology， Pingxiang People′s Hospital， Jiangxi Province， Pingxiang? ?337000， China

[Abstract] Objective To compare the clinical effect of laparoscopic and laparotomic hysteromyomectomy in the treatment of uterine fibroids. Methods A total of 150 patients with uterine fibroids admitted to the hospital from June 2016 to September 2018 were selected as subjects. They were divided into the control group （n=100） and the observation group （n=50） by the random touch ball method. Patients in the control group were treated with laparotomic hysteromyomectomy， while patients in the observation group were mainly treated with laparoscopic hysteromyomectomy. The amount of bleeding， exhaust time， hospital stay， operation time and occurrence of postoperative complications were compared between the two groups. Results In the observation group， the amount of peroperative bleeding was less than that of the control group， the operation time was longer than that of the control group， and the hospital stay and postoperative exhaust time were shorter compared with those in the control group， the differences were statistically significant （t=123.518， 9.980， 16.568， 5.732; P<0.05）. The total incidence of complications in the observation group was 2.00% （1/50）， which was lower than that in the control group accounting for 7.00% （7/100）， the difference was statistically significant （χ2=8.510， P<0.05）. There were no significant differences in the rates of uterine fibroid recurrence， uterine abnormalities， and symptom relief between the two groups （P>0.05）. Conclusion Application of laparoscopic hysteromyomectomy for uterine fibroids can effectively shorten the hospital stay and reduce the amount of intraoperative blood loss， control complications， and obtains a remarkable effect， which has clinical application value.

[Key words] Laparoscope; Laparotomic hysteromyomectomy; Uterine fibroids; Clinical effect

子宮肌瘤也被稱之為子宮纖維瘤、纖維肌瘤，為一種常見的女性良性腫瘤，也為臨床多發(fā)腫瘤。子宮平滑肌細(xì)胞為子宮肌瘤的重要生成原因，此種肌瘤僅有少量纖維結(jié)締組織進(jìn)行支持，因此臨床被稱之為子宮平滑肌肌瘤。多數(shù)研究認(rèn)為子宮肌瘤為激素依賴性腫瘤，雌激素為肌瘤持續(xù)生長的重要原因[1]。也有分析認(rèn)為劑量大小和生長激素有關(guān)，在人體內(nèi)協(xié)同雌激素可加速有絲分裂[2]。臨床多采用開腹手術(shù)對(duì)子宮肌瘤進(jìn)行剔除，此種治療方式的創(chuàng)傷較小，但會(huì)引發(fā)多種并發(fā)癥，因此需要尋找合適的治療方式進(jìn)行替代。隨著腹腔鏡技術(shù)的發(fā)展，有學(xué)者提出在腹腔鏡下進(jìn)行子宮肌瘤剔除，可降低手術(shù)創(chuàng)傷，提升治療效果[3]。……