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目的探讨腹腔镜子宫剔除术与开腹手术的治疗效果,并对比分析两组手术治疗后肌瘤残留、复发及妊娠结局。方法将南阳市中心医院2010年5月至2012年3月收治的126例子宫肌瘤患者进行分组治疗。治疗组63例采取腹腔镜子宫肌瘤剔除术治疗,对照组63例采取开腹手术治疗。对比分析两组患者术中出血量、肌瘤剔除个数、肛门排气时间、住院时间以及术后肌瘤残留、复发及妊娠结局。结果治疗组术中出血量、肛门排气时间以及住院时间均明显低于对照组,差异有统计学意义(P<0.05)。两组肌瘤剔除个数、术后肌瘤残留、复发率与妊娠率比较差异无统计学意义(P>0.05)。所有术后妊娠患者均未出现子宫破裂。结论腹腔镜子宫剔除术治疗子宫肌瘤与传统开腹手术相比,具有出血量少、住院时间短等优点。对于有保留生育能力意愿的患者,腹腔镜子宫剔除术是安全、有效的一种治疗方式。但腹腔镜子宫剔除术的肌瘤残留与开腹手术治疗相比,残留率较高,但术后短期复发率差异不明显。
Objective To investigate the therapeutic effect of laparoscopic hysterectomy and laparotomy, and to compare the residual, recurrence and pregnancy outcome of the two groups after operation. Methods A total of 126 cases of uterine fibroids were treated in Nanyang Central Hospital from May 2010 to March 2012. 63 cases in the treatment group were treated by laparoscopic myomectomy and 63 cases in the control group were treated by laparotomy. The blood loss, the number of myomectomy, anal exhaust time, hospital stay, postoperative fibroid residue, recurrence and pregnancy outcome were compared between the two groups. Results The blood loss, anal exhaust time and hospital stay in the treatment group were significantly lower than those in the control group (P <0.05). The number of myomectomy, postoperative residual fibroids, recurrence rate and pregnancy rate was no significant difference (P> 0.05). Uterine rupture did not occur in all postoperative patients. Conclusion Laparoscopic hysterectomy for the treatment of uterine fibroids compared with the traditional laparotomy, with less bleeding, shorter hospital stay and so on. Laparoscopic hysterectomy is a safe and effective treatment for patients who have the intent to maintain fertility. However, laparoscopic hysterectomy fibroids residual surgery and open surgery compared to a higher residual rate, but postoperative short-term recurrence rate difference was not obvious.