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目的:比较经阴道子宫肌瘤剔除术(transvaginal myomectomy,TVM)与腹腔镜子宫肌瘤剔除术(laparoscopic myomec-tomy,LM)的临床治疗效果、安全性及经济效益。方法:选取南京市妇幼保健院妇科在2009年1月～2010年12月收治的因子宫肌瘤而行剔除手术的患者80例。其中接受TVM的患者30例(A组),LM的患者50例(B组),比较两组患者的一般资料、手术时间、术中出血量、术后恢复情况、手术费用和术后随访情况。结果:A组与B组手术时间无统计学差异,B组出血量明显少于A组(P<0.05),术后血红蛋白下降显著小于A组(P<0.05);两组患者术后病率无明显差异;A组肠功能恢复后的排气时间明显短于B组、术后患者的住院时间长于B组,差异有统计学意义;手术费用及住院总费用A组均明显低于B组;门诊随访两组无明显差异。结论:TVM与LM疗效及安全性相当,TVM可有效减轻患者个人和社会医疗负担,临床医师可根据自己的经验和适应证选择TVM或LM。
Objective: To compare the clinical effects, safety and economic benefits of transvaginal myomectomy (TVM) and laparoscopic myomectomy (LM). Methods: Eighty patients undergoing gynecological myomectomy from March 2009 to December 2010 in Nanjing Maternal and Child Health Hospital were enrolled. Among them, 30 patients (group A) and 50 patients (group B) received TVM. The general data, operation time, intraoperative blood loss, postoperative recovery, operation costs and postoperative follow-up were compared between the two groups . Results: There was no significant difference in operative time between group A and group B, and the bleeding volume in group B was significantly less than that in group A (P <0.05). The postoperative hemoglobin decreased significantly less than that in group A (P <0.05). The postoperative morbidity No significant difference; A group of intestinal function recovery after evacuation time was significantly shorter than the B group, postoperative patients hospitalization longer than the B group, the difference was statistically significant; surgery costs and hospitalization costs A group were significantly lower than the B group There was no significant difference between the two groups in follow-up. Conclusion: TVM and LM are effective and safe. TVM can effectively reduce the personal and social medical burden on patients. Clinicians can choose TVM or LM according to their own experience and indications.