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目的探讨经阴道子宫肌瘤剔除术治疗中老年子宫肌瘤合并高血压患者的疗效,并观察炎性因子水平。方法选择2014年3月-2015年12月在十堰市太和医院治疗的180例子宫肌瘤患者研究对象,将其分为A、B、C三组。A组30例,采用经阴道子宫肌瘤剔除术治疗;B组60例,采用腹腔镜下子宫肌瘤剔除术治疗;C组90例,采用开腹子宫肌瘤剔除术治疗。术后就其疗效、手术时间、术中出血量、剔除肌瘤数量、术后肛门排气通气时间、住院时间等相关数据及炎性因子水平进行组间比较。结果三组的总有效率依次增高,但差异无统计学意义(χ~2=2.386、2.013、2.265,均P>0.05)。A组术中出血量、术后肛门排气通气时间及住院时间显著优于B组和C组(P<0.05),同时B组显著优于C组(P<0.05);A组和B组手术时间比较,差异无统计学意义(P>0.05),C组手术时间显著短于A组和B组(P<0.05);C组剔除肌瘤数量最多,B组最少,且三组间比较,差异均具有统计学意义(P<0.05)。三组的IL-6、CRP及TNF-α水平依次增高,组间比较,差异有统计学意义(χ~2=4.568、6.956、5.235,均P<0.05)。结论经阴道子宫肌瘤剔除术是治疗中老年子宫肌瘤合并高血压患者的有效治疗方式,且能显著改善炎性因子、术中出血量及康复时间。
Objective To investigate the efficacy of transvaginal myomectomy in the treatment of middle-aged and elderly patients with uterine fibroids complicated with hypertension and to observe the levels of inflammatory cytokines. Methods 180 patients with uterine fibroids treated in Taihe Hospital of Shiyan from March 2014 to December 2015 were selected and divided into three groups (A, B and C). A group of 30 cases, the treatment of transvaginal myomectomy; B group of 60 cases, the use of laparoscopic myomectomy; C group of 90 cases, the use of laparotomy myomectomy. The postoperative efficacy, operation time, intraoperative bleeding, the number of fibroids removed, postoperative anal exhaust time, hospitalization time and other related data and levels of inflammatory factors were compared between groups. Results The total effective rate of three groups increased in turn, but the difference was not statistically significant (χ ~ 2 = 2.386,2.013,2.265, all P> 0.05). The blood loss, time of postoperative anal exhaust and hospital stay in group A were significantly better than those in group B and group C (P <0.05), while group B was significantly better than group C (P <0.05); Group A and group B There was no significant difference in operative time between the two groups (P> 0.05). The operation time of group C was significantly shorter than that of group A and group B (P <0.05), while the number of fibroids was the largest in group C and the group B was the least , The differences were statistically significant (P <0.05). The levels of IL-6, CRP and TNF-α in the three groups increased in turn, with statistical significance between the two groups (χ ~ 2 = 4.568,6.956,5.235, all P <0.05). Conclusion Transvaginal myomectomy is an effective treatment for middle-aged and elderly patients with uterine fibroids and hypertension, and can significantly improve the inflammatory factors, blood loss and recovery time.