目的探讨腹腔镜子宫肌瘤剔除术、经阴道子宫肌瘤剔除术及经腹子宫肌瘤剔除术三种术式对患者预后的影响。方法设腹腔镜组、经阴组和开腹组,每组各选单发子宫肌瘤<5 cm患者20例、单发子宫肌瘤>5 cm患者20例和多发子宫肌瘤20例。观察三种术式手术时间、出血量、术后排气时间、体温恢复正常时间及术后住院天数。结果 1对直径<5 cm单发子宫肌瘤剔除术:手术时间、术中出血量、术后排气时间及术后住院时间开腹组多于其他两组,差异有具有统计学意义(P<0.05);体温恢复时间经阴组﹥开腹组﹥腹腔镜组,两两比较差异有统计学意义(P<0.05);2对直径>5 cm单发子宫肌瘤剔除术:手术时间、术中出血量及体温恢复正常时间经阴组多于其他两组,差异有统计学意义(P<0.05);术后排气时间开腹组长于其他两组,差异有统计学意义(P<0.05);术后住院天数腹腔镜组少于其他两组,差异有统计学意义(P<0.05);3对多发子宫肌瘤剔除术:手术时间及体温恢复正常时间经阴组多于其他两组,差异有统计学意义(P<0.05);术后排气时间开腹组长于其他两组,差异有统计学意义(P<0.05);术中出血量经阴组﹥腹腔镜组﹥开腹组,两两比较差异有统计学意义(P<0.05);术后住院天数腹腔镜组少于其他两组,差异有统计学意义(P<0.05)。结论 1对于单发:直径<5 cm的子宫肌瘤患者术后预后腹腔镜组优于经阴组,经阴组优于开腹组;2对于单发:直径>5 cm的子宫肌瘤患者术后预后腹腔镜组优于开腹组,开腹组优于经阴组;3对于多发子宫肌瘤患者术后预后开腹组优于腹腔镜组,腹腔镜组优于经阴组。 Objective To investigate the effects of laparoscopic myomectomy, vaginal myomectomy and abdominal myomectomy on the prognosis of patients. Methods A total of 20 patients with single myoma of uterus <5 cm, 20 patients with single uterine fibroids> 5 cm and 20 patients with multiple uterine fibroids were enrolled in this study. The operation time, blood loss, postoperative exhaust time, body temperature recovery time and postoperative hospital stay were observed. Results 1 pairs of single myomectomy less than 5 cm in diameter: operation time, blood loss, postoperative exhaust time and postoperative hospital stay more than the other two groups, the difference was statistically significant (P (P <0.05). The body temperature recovery time was significantly lower than that of the control group (P> 0.05). The time of body temperature recovery was significantly higher than that of the laparoscopic group (P <0.05) The amount of blood loss and body temperature returned to normal in the time-dependent group were significantly higher than those in the other two groups (P <0.05). The time of postoperative exhaust was longer in the open group than in the other two groups, with significant difference (P < 0.05). The number of postoperative days in laparoscopic group was less than that in other two groups (P <0.05) .3 Three cases of multiple myomectomy: the operation time and body temperature returned to normal Group, the difference was statistically significant (P <0.05); postoperative exhaust time in the open group longer than the other two groups, the difference was statistically significant (P <0.05); intraoperative blood loss by the negative group> laparoscopic group> open The difference between the two groups was statistically significant (P <0.05). The length of postoperative hospital stay was less in the laparoscopic group than in the other two groups (P <0.05) . Conclusions1 For single hair: the prognosis of patients with uterine fibroids less than 5 cm in diameter is better than the group receiving perineum, and the group with perineum is superior to the group with open laparotomy. 2 For patients with uterine fibroids with single diameter> 5 cm The postoperative prognosis of laparoscopic group was better than that of laparotomy group, and the laparotomy group was superior to the perineum group.3. The prognosis of open uterine fibroids group was better than that of laparoscopic group in laparoscopic group.