摘要
目的评价开腹、腹腔镜下及阴式子宫肌瘤剔除术的优缺点和手术适应证。方法回顾分析北京协和医院2005年1月至2006年6月同期行开腹子宫肌瘤剔除术81例、腹腔镜下子宫肌瘤剔除术148例和阴式子宫肌瘤剔除术10例的临床资料,选出相匹配的组别分别进行比较,分析其一般临床资料及围手术期资料特点。结果阴式组与相匹配的腹腔镜组比较:住院费用阴式组明显少于腹腔镜组[(4669±1080)元对(6187±945)元],术后肛门排气时间阴式组明显短于腹腔镜组[(14.8±2.6)h对(18.8±3.1)h],差异有统计学意义(P<0.05)。术后住院时间阴式组长于腹腔镜组[(4.1±1.9)d对(2.6±0.9)d,P<0.05);单发肌壁间肌瘤腹腔镜组与相匹配的开腹组相比,术后住院时间腹腔镜组明显短于开腹组[(3.2±0.9)d对(6.0±0.94)d],术后病率和术后镇痛药使用率腹腔镜组亦明显少于开腹组(5.88%对41.18%,8.82%对35.29%),手术时间腹腔镜组明显长于开腹组[(106.9±42.0)min对(74.8±27.1)min),均P<0.05。结论腹腔镜下及阴式肌瘤剔除术均为微创术式,两种术式均安全可靠;阴式肌瘤剔除术住院费用更少,对腹腔干扰更小,而多发(≥5个)、巨大或剔除术后复发的肌瘤首选开腹肌瘤剔除术。
Objective To analyze the advantages, disadvantages and indications of transabdominal myomectomy （TAM） ,laparoscopic myomectomy（LM） and transvaginal mymectomy（TVM）. Methods A total of 81 cases of TAM, 148 cases of LM and 10 cases of TVM were retrospectively assessed. Results When Group TVM was compared with the comparable group LM, it had significantly lower hospitalization cost, shorter time of passage of gas by anus, but had longer hospital stay than the later. Group LM（ sigle intramural myoma） had significantly shorter hospital stay, lower usage rate of pain-killer,lower postoperative blood loss, but longer operation time than the comparable group TAM （ single intramural myoma） （P 〈0. 05 ）. Condusion Both TVM and LM are micro -invasive operation. TVM costs much less and has quicker recovery of bowel movement. But when the myomas are more than 5, huge, or recurrent after myomectomy, TAM is first recommended.
出处
《中国实用妇科与产科杂志》
CAS
CSCD
北大核心
2008年第4期278-281,共4页
Chinese Journal of Practical Gynecology and Obstetrics
