腹腔镜较传统开腹子宫肌瘤剔除术治疗子宫肌瘤的临床效果及安全性分析
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摘要
目的探讨腹腔镜较传统开腹子宫肌瘤剔除术治疗子宫肌瘤的临床效果及安全性。方法选取行子宫肌瘤剔除术的患者86例,按照手术治疗方案不同分为传统开腹组(n=45)和腹腔镜组(n=41),比较2组患者手术时长、术中出血量、术后住院时间等手术评价指标,并通过观察2组患者术后并发症发生率判断2种手术治疗方案的安全性。结果 2组患者手术时长、肌瘤剔除个数、剔除肌瘤直径、肌瘤残留率相比,差异均无统计学意义(P> 0. 05);而腹腔镜组患者的术中出血量、术后住院时间、术后排气时间(63. 42±23. 22 m L、5. 89±1. 24 d、14. 23±4. 78 h)均明显优于传统开腹组的(109. 24±31. 85 m L、14. 87±5. 45 d、25. 33±6. 11 h)(P <0. 05),腹腔镜组患者术后并发症发生率(7. 32%)明显低于传统开腹组的(24. 44%)(P <0. 05)。结论腹腔镜下行子宫肌瘤剔除术与传统开腹手术方案的临床疗效相当,但前者创伤性更小,术后恢复快、并发症发生率低,更易为患者接受。
Objective To investigate and compare the efficacy and safety of laparoscopic cholecystectomy with uterine leiomyoma in the treatment of uterine fibroids. Methods A retrospective analysis was made on the data of 86 patients diagnosed as uterine fibroids with myomectomy. All patients were divided into the traditional open group( n = 45) and laparoscopic group( n= 41) according to the different surgical regimen. To compare the 2 groups of patients with surgical duration,intraoperative blood loss,postoperative hospital stay and other surgical efficacy evaluation indicators,and by observing the incidence of postoperative complications of the 2 groups to determine the safety of the 2 surgical treatment program. Results There were no significant differences in the length of operation,the number of myoma ablation,the diameter of fibroids and the residual rate of fibroids in the 2 groups( P > 0. 05). The laparoscopic group of patients( 63. 42 ± 23. 22 m L、5. 89 ± 1. 24 d、14. 23 ± 4. 78 h) with intraoperative blood loss,postoperative hospital stay,postoperative exhaust time were significantly better than the traditional open group( 109. 24 ± 31. 85 m L、14. 87 ± 5. 45 d、25. 33 ± 6. 11 h)( P < 0. 05); The incidence of postoperative complications in the laparoscopic group was significantly lower than that in the traditional laparotomy group( P < 0. 05). Conclusion Laparoscopic myomectomy with traditional laparotomy is similar to that of traditional laparotomy. However,the former is less invasive,and it has the advantages of quick recovery after operation and low incidence of complications.
Objective To investigate and compare the efficacy and safety of laparoscopic cholecystectomy with uterine leiomyoma in the treatment of uterine fibroids. Methods A retrospective analysis was made on the data of 86 patients diagnosed as uterine fibroids with myomectomy. All patients were divided into the traditional open group( n = 45) and laparoscopic group( n= 41) according to the different surgical regimen. To compare the 2 groups of patients with surgical duration,intraoperative blood loss,postoperative hospital stay and other surgical efficacy evaluation indicators,and by observing the incidence of postoperative complications of the 2 groups to determine the safety of the 2 surgical treatment program. Results There were no significant differences in the length of operation,the number of myoma ablation,the diameter of fibroids and the residual rate of fibroids in the 2 groups( P > 0. 05). The laparoscopic group of patients( 63. 42 ± 23. 22 m L、5. 89 ± 1. 24 d、14. 23 ± 4. 78 h) with intraoperative blood loss,postoperative hospital stay,postoperative exhaust time were significantly better than the traditional open group( 109. 24 ± 31. 85 m L、14. 87 ± 5. 45 d、25. 33 ± 6. 11 h)( P < 0. 05); The incidence of postoperative complications in the laparoscopic group was significantly lower than that in the traditional laparotomy group( P < 0. 05). Conclusion Laparoscopic myomectomy with traditional laparotomy is similar to that of traditional laparotomy. However,the former is less invasive,and it has the advantages of quick recovery after operation and low incidence of complications.
引文
[1]张国杰.腹腔镜子宫肌瘤剔除后不同止血方式的对比分析[J].中国民族民间医药杂志,2010,19(23):91-92.
[2] Chittawar PB,Kamath MS. Review of nonsurgical/minimally invasive treatments and open myomectomy for uterine fibroids[J]. Curr Opin Obstet Gynecol,2015,27(6):391.
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[4] Odejinmi F,Maclaran K,Agarwal N. Laparoscopic treatment of uterine fibroids:a comparison of peri-operative outcomes inlaparoscopic hysterectomy and myomectomy[J]. Arch Gynecol Obstet,2015,291(3):579-584.
[5]程松梅.腹腔镜微创手术与传统开腹手术治疗子宫肌瘤的疗效比较[J].当代医学,2017,23(2):38-39.
[6]隋敏.腹腔镜下子宫肌瘤剔除术的临床疗效观察[J].中国现代医生,2010,48(14):156-157.
[7]刘艳云.腹腔镜手术治疗子宫肌瘤的临床分析[J].中国医学创新,2012,9(31):142-143.
[8] Goldman KN,Hirshfeld-Cytron JE,Pavone ME,et al. Uterine artery embolization immediately preceding laparoscopic myomectomy[J]. Gynaecol Obstet,2012,116(2):105.
[9] Mara M,Kubinova K,Maskova J,et al. Uterine artery embolization versus laparoscopic uterine artery occlusion:the outcomes of a prospective,nonrandomized clinical trial[J].Cardiovasc Intervent Radiol,2012,35(5):1041.
[10]陶云鹏.腹腔镜下子宫肌瘤剔除术的疗效评估[J].湖北科技学院学报(医学版),2017,31(2):146-147.
[11] Maclaran K,Agarwal N,Odejinmi F. Co-existence of uterine myomas and endometriosis in women undergoing laparoscopicmyomectomy:risk factors and surgical implications[J]. Minim Invasive Gynecol,2014,21(6):1086-1090.
[12] Vercellino G,Erdemoglu E,Joe A,et al. Laparoscopic temporary clipping of uterine artery during laparoscopic myomectomy[J]. Arch Gynecol Obstet,2012,286(5):1181.
[13]丁友明.腹腔镜与开腹行子宫肌瘤剔除术的疗效分析[J].中国卫生产业,2012,9(11):96.
[14]饶龙泉.腹腔镜手术治疗子宫肌瘤的临床分析[J].吉林医学,2014,35(12):2628-2628.
[15] Tulandi T,Ferenczy A. Biopsy of uterine leiomyomata and frozen sections before laparoscopic morcellation[J]. Minim Invasive Gynecol,2014,21(5):963-966.
[16]王淑贞.腹腔镜子宫肌瘤剔除术与开腹手术治疗后肌瘤残留、复发及妊娠结局的对比研究[J].中国实用医刊,2014,41(19):100-101.
[17]黄鑫,张璐芳,侯征,等.腹腔镜下子宫肌瘤剔除术中子宫创面缝合方法的探讨[J].中国微创外科杂志,2013,13(11):1005-1008.
[2] Chittawar PB,Kamath MS. Review of nonsurgical/minimally invasive treatments and open myomectomy for uterine fibroids[J]. Curr Opin Obstet Gynecol,2015,27(6):391.
[3]魏玉华.腹腔镜与开腹子宫肌瘤剔除术的疗效比较研究[J].中华全科医学,2013,11(3):429.
[4] Odejinmi F,Maclaran K,Agarwal N. Laparoscopic treatment of uterine fibroids:a comparison of peri-operative outcomes inlaparoscopic hysterectomy and myomectomy[J]. Arch Gynecol Obstet,2015,291(3):579-584.
[5]程松梅.腹腔镜微创手术与传统开腹手术治疗子宫肌瘤的疗效比较[J].当代医学,2017,23(2):38-39.
[6]隋敏.腹腔镜下子宫肌瘤剔除术的临床疗效观察[J].中国现代医生,2010,48(14):156-157.
[7]刘艳云.腹腔镜手术治疗子宫肌瘤的临床分析[J].中国医学创新,2012,9(31):142-143.
[8] Goldman KN,Hirshfeld-Cytron JE,Pavone ME,et al. Uterine artery embolization immediately preceding laparoscopic myomectomy[J]. Gynaecol Obstet,2012,116(2):105.
[9] Mara M,Kubinova K,Maskova J,et al. Uterine artery embolization versus laparoscopic uterine artery occlusion:the outcomes of a prospective,nonrandomized clinical trial[J].Cardiovasc Intervent Radiol,2012,35(5):1041.
[10]陶云鹏.腹腔镜下子宫肌瘤剔除术的疗效评估[J].湖北科技学院学报(医学版),2017,31(2):146-147.
[11] Maclaran K,Agarwal N,Odejinmi F. Co-existence of uterine myomas and endometriosis in women undergoing laparoscopicmyomectomy:risk factors and surgical implications[J]. Minim Invasive Gynecol,2014,21(6):1086-1090.
[12] Vercellino G,Erdemoglu E,Joe A,et al. Laparoscopic temporary clipping of uterine artery during laparoscopic myomectomy[J]. Arch Gynecol Obstet,2012,286(5):1181.
[13]丁友明.腹腔镜与开腹行子宫肌瘤剔除术的疗效分析[J].中国卫生产业,2012,9(11):96.
[14]饶龙泉.腹腔镜手术治疗子宫肌瘤的临床分析[J].吉林医学,2014,35(12):2628-2628.
[15] Tulandi T,Ferenczy A. Biopsy of uterine leiomyomata and frozen sections before laparoscopic morcellation[J]. Minim Invasive Gynecol,2014,21(5):963-966.
[16]王淑贞.腹腔镜子宫肌瘤剔除术与开腹手术治疗后肌瘤残留、复发及妊娠结局的对比研究[J].中国实用医刊,2014,41(19):100-101.
[17]黄鑫,张璐芳,侯征,等.腹腔镜下子宫肌瘤剔除术中子宫创面缝合方法的探讨[J].中国微创外科杂志,2013,13(11):1005-1008.