腹腔镜手术在治疗子宫肌瘤上的应用价值(1)
摘要：目的：探讨腹腔镜手术在治疗子宫肌瘤上的应用价值。方法： 收集我院妇科近4年共计120例诊断为子宫肌瘤的患者作为研究对象。按随机数字表法分为2组，腹腔镜组60例和开腹组60例。腹腔镜组采用腹腔镜下子宫肌瘤切除术;开腹组采用开腹子宫肌瘤剔除术。比较(1)腹腔镜组与开腹组手术时间、手术出血量、术后住院天数;(2)腹腔镜组与开腹组盆腔粘连率及子宫肌瘤复发率。结果：腹腔镜组与开腹组手术时间、手术出血量、术后住院天数分别为(109.6±15.4min、97.6±13.6ml、4.6±1.4d)、(94.7±7.6min、134.9±25.7ml、7.5±2.9d)，差异有统计学意义(P<0.05);腹腔镜组与开腹组盆腔粘连率及子宫肌瘤复发率分别为(11.7%、13.3%)、(36.6%、30%)，两组盆腔粘连率差异有统计学意义(P<0.05)，两组子宫肌瘤复发率差异无统计学意义(P>0.05)。结论：本次研究认为腹腔镜下子宫肌瘤切除术的优点是患者手术出血量少，术后住院天数短，但是对于较小的肌瘤探测效果差，术后有复发几率。
关键词：腹腔镜 ;开腹 ;子宫肌瘤;价值
, http://www.100md.com
Abstract：Objective To investigate the value of laparoscopic surgery in the treatment of uterine fibroids.Methods Collected our hospital gynecological 120 cases diagnosed with uterine fibroids in recent 4 yearsas as research subjects.randomly divided into 2 groups，the laparoscopic group and laparotomy group each in 60 cases，the laparoscopic group with laparoscopic myomectomy，and the laparotomy group with abdominal myomectomy，compared two group’s operative time，blood loss，postoperative hospital stay，and pelvic adhesions rate and uterine fibroids recurrence rate.Results The laparoscopic group and laparotomy group’s operative time，blood loss，postoperative hospital stay were(109.6±15.4min、97.6±13.6ml、4.6±1.4d)、(94.7±7.6min、134.9±25.7ml、7.5±2.9d)，the difference was statistically significant(P<0.05).the pelvic adhesions rate and uterine fibroids recurrence rate were(11.7%、13.3%)、(36.6%、30%)，and the pelvic adhesions rate had significant difference(P<0.05)，the uterine fibroids recurrence rate had no significant difference(P>0.05).Conclusion This study suggests that the advantages of laparoscopic myomectomy were less bleeding in surgery，short postoperative hospital stay，but for the small fibroids，the detection was poor，and there was the risk of recurrence after surgery.
, 百拇医药
子宫肌瘤是女性生殖器最常见的肿瘤，患病率可达30%～50%[1]。肌瘤发生恶变的倾向约0.4%～0.8%。多数患者无症状，仅在超声检查时发现。临床表现与子宫肌瘤生长部位、有无变性密切相关，而与肌瘤大小、数目相对较小，如多个浆膜下肌瘤者未必有症状，而一个较小的黏膜下肌瘤常可引起不规则阴道流血。目前医学界对有症状的子宫肌瘤患者，主张手术治疗为主。近年来，但随着微创技术及设备的发展，腹腔镜和宫腔镜逐步代替传统手术治疗子宫肌瘤，优点为患者创伤小、恢复快。因此本次研究的目的为探讨腹腔镜手术在治疗子宫肌瘤上的应用价值。
1 资料与方法
1.1 资料 收集我院妇科近4年共计120例诊断为子宫肌瘤的患者作为研究对象。按随机数字表法分为2组，腹腔镜组60例和开腹组60例。腹腔镜组平均年龄(37.3±9.4)岁，采用腹腔镜下子宫肌瘤切除术;开腹组采用开腹子宫肌瘤剔除术，平均年龄(38.2±7.5)岁。2组人员性别，年龄差异无统计学意义。所有研究对象均签定知情同意书，保密知情书，本次研究通过医院伦理道德委员会的批准、核实。
1.2 入选标准 (1)就诊时临床资料、治疗经过完整。(2)子宫肌瘤的诊断符合中华医学会妇科学分会关于子宫肌瘤的诊断与鉴别诊断，术后有明确的病理证实。(3)超声检查子宫肌瘤数目<3个、壁间肌瘤直径3～8cm。
1.3 排除指标：(1)入院时生命体征不平稳的患者。(2)入院有各种急性、慢性感染，严重肝、肾功能不全，恶性肿瘤，自身免疫性疾病者，药物有过敏、恶性心律失常者。, http://www.100md.com(刘芙蓉 黄菊芳 张雪辉 邓越文)
关键词：腹腔镜 ;开腹 ;子宫肌瘤;价值
, http://www.100md.com
Abstract：Objective To investigate the value of laparoscopic surgery in the treatment of uterine fibroids.Methods Collected our hospital gynecological 120 cases diagnosed with uterine fibroids in recent 4 yearsas as research subjects.randomly divided into 2 groups，the laparoscopic group and laparotomy group each in 60 cases，the laparoscopic group with laparoscopic myomectomy，and the laparotomy group with abdominal myomectomy，compared two group’s operative time，blood loss，postoperative hospital stay，and pelvic adhesions rate and uterine fibroids recurrence rate.Results The laparoscopic group and laparotomy group’s operative time，blood loss，postoperative hospital stay were(109.6±15.4min、97.6±13.6ml、4.6±1.4d)、(94.7±7.6min、134.9±25.7ml、7.5±2.9d)，the difference was statistically significant(P<0.05).the pelvic adhesions rate and uterine fibroids recurrence rate were(11.7%、13.3%)、(36.6%、30%)，and the pelvic adhesions rate had significant difference(P<0.05)，the uterine fibroids recurrence rate had no significant difference(P>0.05).Conclusion This study suggests that the advantages of laparoscopic myomectomy were less bleeding in surgery，short postoperative hospital stay，but for the small fibroids，the detection was poor，and there was the risk of recurrence after surgery.
, 百拇医药
子宫肌瘤是女性生殖器最常见的肿瘤，患病率可达30%～50%[1]。肌瘤发生恶变的倾向约0.4%～0.8%。多数患者无症状，仅在超声检查时发现。临床表现与子宫肌瘤生长部位、有无变性密切相关，而与肌瘤大小、数目相对较小，如多个浆膜下肌瘤者未必有症状，而一个较小的黏膜下肌瘤常可引起不规则阴道流血。目前医学界对有症状的子宫肌瘤患者，主张手术治疗为主。近年来，但随着微创技术及设备的发展，腹腔镜和宫腔镜逐步代替传统手术治疗子宫肌瘤，优点为患者创伤小、恢复快。因此本次研究的目的为探讨腹腔镜手术在治疗子宫肌瘤上的应用价值。
1 资料与方法
1.1 资料 收集我院妇科近4年共计120例诊断为子宫肌瘤的患者作为研究对象。按随机数字表法分为2组，腹腔镜组60例和开腹组60例。腹腔镜组平均年龄(37.3±9.4)岁，采用腹腔镜下子宫肌瘤切除术;开腹组采用开腹子宫肌瘤剔除术，平均年龄(38.2±7.5)岁。2组人员性别，年龄差异无统计学意义。所有研究对象均签定知情同意书，保密知情书，本次研究通过医院伦理道德委员会的批准、核实。
1.2 入选标准 (1)就诊时临床资料、治疗经过完整。(2)子宫肌瘤的诊断符合中华医学会妇科学分会关于子宫肌瘤的诊断与鉴别诊断，术后有明确的病理证实。(3)超声检查子宫肌瘤数目<3个、壁间肌瘤直径3～8cm。
1.3 排除指标：(1)入院时生命体征不平稳的患者。(2)入院有各种急性、慢性感染，严重肝、肾功能不全，恶性肿瘤，自身免疫性疾病者，药物有过敏、恶性心律失常者。, http://www.100md.com(刘芙蓉 黄菊芳 张雪辉 邓越文)