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目的探讨腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤的临床效果。方法选取2014年6月—2016年5月湖南医药学院第一附属医院妇产科收治的巨大子宫肌瘤患者98例。按照随机数字表法将患者分为开腹组和腹腔镜组,各49例。开腹组实施传统开腹子宫切除术治疗,腹腔镜组实施腹腔镜辅助阴式全子宫切除术治疗,比较两组患者临床指标(手术时间、术中失血量、术后开始下床活动时间、术后住院时间)。随访3个月,观察两组患者并发症发生情况,随访结束时行影像学检查观察阴道残端恢复情况及盆腔检测结果。结果腹腔镜组手术时间长于开腹组,术中失血量少于开腹组,术后开始下床活动时间、住院时间短于开腹组(P<0.05)。腹腔镜组并发症发生率低于开腹组(P<0.05)。两组患者术后随访时超声检查均显示阴道残端愈合较好,且盆腔检测均显示正常。结论腹腔镜辅助阴式全子宫切除术治疗巨大子宫肌瘤患者可有效减少创伤、并发症,促进患者术后恢复。
Objective To investigate the clinical effect of laparoscopic assisted vaginal hysterectomy in treating giant uterine fibroids. Methods From June 2014 to May 2016, 98 patients with giant uterine fibroids were admitted to the Department of Obstetrics and Gynecology, the First Affiliated Hospital of Hunan Medical University. Patients were divided into laparotomy group and laparoscopic group according to random number table method, 49 cases in each group. In the laparotomy group, laparoscopic-assisted vaginal hysterectomy was performed in the laparoscopic group. The clinical parameters of the two groups were compared (operation time, intraoperative blood loss, time to get out of bed after surgery, Postoperative hospital stay). The patients were followed up for 3 months. The complications of the two groups were observed. At the end of follow-up, the vaginal stump recovery and pelvic examination were observed by imaging examination. Results The operation time of laparoscopic group was longer than that of laparotomy group. The intraoperative blood loss was less than that of laparotomy group. The time of starting ambulation after operation was shorter than that of laparotomy group (P <0.05). The incidence of complications in laparoscopic group was lower than that in open group (P <0.05). Ultrasound examination of the two groups of patients after follow-up showed that the healing of vaginal stump was better, and pelvic examination showed normal. Conclusion Laparoscopic assisted vaginal hysterectomy in the treatment of patients with huge uterine fibroids can effectively reduce trauma, complications, and promote postoperative recovery.