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目的探讨腹腔镜下子宫肌瘤挖出手术的临床应用价值。方法随机选取2005年1月到2007年4月在我院行腹腔镜子宫肌瘤挖出术35例,同期开腹子宫肌瘤挖出术31例,两组在手术时间、术中出血量以及术后肠功能恢复、体温恢复的情况的对比研究。结果腹腔镜组中2例因瘤穴深,出血多,缝合困难中转开腹。开腹组均顺利完成手术,除去中转开腹2例,则腹腔镜组手术时间为(91±32)min,与开腹组(78±21)min比较,差异无统计学意义(P>0.05)。腹腔镜组出血量(106±31)ml,少于开腹组(108±55)ml,差异有统计学意义(P<0.05)。腹腔镜组术后肛门排气时间(12.5±1.2)h,体温恢复正常时间(24±9)h,均短于开腹组(36±5)h、(39±3)h。差异有统计学意义(P<0.01)。结论腹腔镜下子宫肌瘤挖出术具有创伤小,术中出血少,术后恢复快等优点。但需选择合适病例,不能完全取代开腹手术。
Objective To investigate the clinical value of laparoscopic uterine fibroids excision. Methods From January 2005 to April 2007, 35 cases of laparoscopic uterine fibroids were excised in our hospital, and 31 cases of open uterine fibroids were excised in the same period. The operation time, intraoperative blood loss, Postoperative bowel function recovery, recovery of body temperature compared the situation. Results In the laparoscopic group, 2 cases had deep lacunar and hemorrhage due to tumor, and laparotomy was difficult to transit to laparotomy. In the laparotomy group, the operation was completed smoothly and the laparoscopic surgery was performed in 2 cases (21 cases). The laparoscopic operation time was (91 ± 32) min, which was not significantly different from that in the laparotomy group (78 ± 21) min ). Laparoscopic group bleeding (106 ± 31) ml, less than the open group (108 ± 55) ml, the difference was statistically significant (P <0.05). The time of anus exhaust in laparoscopic group (12.5 ± 1.2 h) and body temperature returned to normal (24 ± 9 h) were shorter than those in open group (36 ± 5 h, 39 ± 3 h). The difference was statistically significant (P <0.01). Conclusion laparoscopic uterine fibroids excavation with less trauma, less bleeding, postoperative recovery and so on. However, the need to select the appropriate case, can not completely replace the open surgery.