延边医学
延邊醫學
연변의학
YAN BIAN YI XUE
2014年
18期
107-109
,共3页
子宫平滑肌瘤%剔除术%手术途径
子宮平滑肌瘤%剔除術%手術途徑
자궁평활기류%척제술%수술도경
fibroid%myomectomy%surgical pathway
目的：探讨经阴道，经腹腔镜，经腹行子宫肌瘤剔除术的可行性、安全性及临床疗效。方法选取我院2009年1月-2012年1月期间156例因患子宫肌瘤而子宫肌瘤剔除术的患者临床资料。按方式不同分为3组，即阴式剔除术组，腹腔镜剔除术组及腹式剔除术组，比较手术效果及术后恢复情况。结果平均手术时间，术中平均出血分别为（80±19）min、（350±60）ml；（82±20）min、（320±72）ml；（78±15）min、（380±71）ml；三组比较，均无显著性差异（P＞0.05）；而经阴道组，经腹腔镜组患者的术后排气时间（15.4±3.2）h，（13.6±3.0）d，术后平均住院时间（4.5±0.5）d，（3.5±0.5）d，均明显短于经腹组（29.5±5.0）h、（8.4±0.4）d。术后疼痛三组比较，差异亦有统计学意义（P＜0.05）。三组患者术后平均随访5.8个月，因月经过多手术者，症状全部改善，与经腹组比较，经阴道组，经腹腔镜组患者术后恢复快，手术效果满意。结论只要适应症选择正确，目前三种子宫肌瘤剔除术式，是临床上安全有效可行的手术方式。经阴道或腹腔镜子宫肌瘤剔除术无手术疤痕或疤痕极小，创伤小，恢复快，并有一定的阴式或腹腔镜手术经验，可优先选择。
目的：探討經陰道，經腹腔鏡，經腹行子宮肌瘤剔除術的可行性、安全性及臨床療效。方法選取我院2009年1月-2012年1月期間156例因患子宮肌瘤而子宮肌瘤剔除術的患者臨床資料。按方式不同分為3組，即陰式剔除術組，腹腔鏡剔除術組及腹式剔除術組，比較手術效果及術後恢複情況。結果平均手術時間，術中平均齣血分彆為（80±19）min、（350±60）ml；（82±20）min、（320±72）ml；（78±15）min、（380±71）ml；三組比較，均無顯著性差異（P＞0.05）；而經陰道組，經腹腔鏡組患者的術後排氣時間（15.4±3.2）h，（13.6±3.0）d，術後平均住院時間（4.5±0.5）d，（3.5±0.5）d，均明顯短于經腹組（29.5±5.0）h、（8.4±0.4）d。術後疼痛三組比較，差異亦有統計學意義（P＜0.05）。三組患者術後平均隨訪5.8箇月，因月經過多手術者，癥狀全部改善，與經腹組比較，經陰道組，經腹腔鏡組患者術後恢複快，手術效果滿意。結論隻要適應癥選擇正確，目前三種子宮肌瘤剔除術式，是臨床上安全有效可行的手術方式。經陰道或腹腔鏡子宮肌瘤剔除術無手術疤痕或疤痕極小，創傷小，恢複快，併有一定的陰式或腹腔鏡手術經驗，可優先選擇。
목적：탐토경음도，경복강경，경복행자궁기류척제술적가행성、안전성급림상료효。방법선취아원2009년1월-2012년1월기간156례인환자궁기류이자궁기류척제술적환자림상자료。안방식불동분위3조，즉음식척제술조，복강경척제술조급복식척제술조，비교수술효과급술후회복정황。결과평균수술시간，술중평균출혈분별위（80±19）min、（350±60）ml；（82±20）min、（320±72）ml；（78±15）min、（380±71）ml；삼조비교，균무현저성차이（P＞0.05）；이경음도조，경복강경조환자적술후배기시간（15.4±3.2）h，（13.6±3.0）d，술후평균주원시간（4.5±0.5）d，（3.5±0.5）d，균명현단우경복조（29.5±5.0）h、（8.4±0.4）d。술후동통삼조비교，차이역유통계학의의（P＜0.05）。삼조환자술후평균수방5.8개월，인월경과다수술자，증상전부개선，여경복조비교，경음도조，경복강경조환자술후회복쾌，수술효과만의。결론지요괄응증선택정학，목전삼충자궁기류척제술식，시림상상안전유효가행적수술방식。경음도혹복강경자궁기류척제술무수술파흔혹파흔겁소，창상소，회복쾌，병유일정적음식혹복강경수술경험，가우선선택。
Objective: To investigate feasibility, safty and clinical effect of vaginal myomectomy. Laparoscopic myomectomy and open myomectowy. Methods: The clinical data of 156 patients with fibroids had myomectomy from Jan 2009 to Jan 2012 were analysed. The patients were decided into three groups accroding to the surgical Pathway, namely VM (Vaginal myomectomy) group, LM (Laparoscopic myomectomy) group and OM,(open myomecto-my) group. The effect of surgery and situation of recovery were compared among these three groups. Results: The operating time and blood loss among three groups were (80±19)min, (350± 60)ml;(82±20)min;(320±72)ml;(78±15)min;(380±71) ml. None of which had significant difference(P>0.05). However, the mean time of postoperative fabulence and hospital stay in VM group (15.4±3.2)h,(13.6±3.0)d, Laparoscopic group of pa-tients with postoperative exhaust time (4.5±0.5)d,(3.5±0.5)d were significantly shorter than those in OM group (29.5±5.0)h (8.4±0.4)d . The differences of postoperative pain time a mony three groups also had statistical significance. Accroding to the postoperative followed-up for an average of 5.8 months, all of the patients with emnorrhagia had been meliorated. Compared with the patient in OM group, those in VM group and LM group recov-ered in a shorter period of time and the clinical effect was more satisfying. Conclusion: As long as the respective indications are selected carefully, the three surgical paths of myomectomy are all feasible, effective and safe. However, the patients chose vaginal myomectomy and laparoscopic myomectomy had no surgical scars or tiny scars. Less trauma and recovered in a shorter period of time. If the expience is sufficient, vaginalor laparoscopic myomec-tomy can be the first choice of the patients. With fibroid.
