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目的:评价腹腔镜子宫肌瘤剔除术的临床应用价值。方法:回顾性分析行开腹子宫肌瘤剔除术患者(Trans-abdominal myomectomy,TAM)145例,并选择同期行腹腔镜子宫肌瘤剔除术患者(Laparoscopic myomectomy,LM)435例,比较其术中与术后情况。结果:两组患者临床特征无明显差异。腹腔镜手术剔除肌瘤1、2～4及多于4个情况下手术时间分别为73.89、116.70及162.41 min,开腹组分别为75.40、95.14及123.33 min。在术中出血量方面,肌瘤个数为1、2～4及多于4个情况下腹腔镜组为105.15、119.70及213.79 ml,开腹组分别为142.90、164.44及191.11 ml。对于单个肌瘤无论肌瘤部位及大小手术时间两组差异无统计学意义(P>0.05),单个肌壁间肌瘤及肌瘤直径<10 cm两组术中出血量差异有统计学意义(P<0.05)。术后腹腔镜组下床活动时间、通气时间及住院日等明显优于开腹组,差异有统计学意义(P<0.05)。结论:腹腔镜子宫肌瘤剔除术与经腹手术相比具有出血量少、术后恢复快的优势。
Objective: To evaluate the clinical value of laparoscopic myomectomy. Methods: A retrospective analysis was performed on 145 patients with TAM (open abdominal myomectomy) and 435 patients undergoing laparoscopic myomectomy (Laparoscopic myomectomy, Laparoscopic myomectomy, With postoperative condition. Results: There was no significant difference in clinical features between the two groups. Laparoscopic surgery excluding fibroids 1,2,4 and more than 4 cases of operation time were 73.89,116.70 and 162.41 min, open group were 75.40,95.14 and 123.33 min. In terms of intraoperative blood loss, the number of fibroids in the 1,2 to 4 and more than 4 cases laparoscopic group was 105.15,119.70 and 213.79 ml, open group were 142.90,164.44 and 191.11 ml. No significant difference was found in the single fibroids between the two groups (P> 0.05), and there was significant difference in intraoperative blood loss among single intramural fibroids and fibroids <10 cm P <0.05). The time of ambulation, ventilation time and hospital stay in the laparoscopic group were significantly better than those in the laparotomy group (P <0.05). Conclusion: Laparoscopic myomectomy has the advantage of less bleeding and faster recovery than abdominal surgery.