CAJ | 학술논문

目的：探讨腹腔镜下子宫肌瘤剔除术与开腹手术的临床治疗效果。方法：选取本院2012年12月-2014年12月接收的行实施腹腔镜下子宫肌瘤剔除手术的患者35例作为观察组，另选择本院往期实施开腹手术治疗的子宫肌瘤患者36例作为对照组，比较两组患者的手术情况及手术后并发症的发生情况。结果：观察组例患者均顺利完成腹腔镜子宫肌瘤剔除术，无一例中转开腹。术中患者均未出现副损伤、大出血等并发症。对照组患者手术过程均顺利，剔除肌瘤个数最多7个，最大直径20 cm，但20 cm肌瘤剔除术中失血量较多，输注红细胞悬液2 U。无术中损伤，1例术后不全肠梗阻，经保守治疗后痊愈。观察组患者的手术时间明显长于对照组，手术出血量及住院费用均明显少于对照组，肛门排气时间及住院天数均明显短于对照组，手术切口明显短于对照组，术后镇痛药物使用率明显低于对照组，比较差异均有统计学意义（P<0.05）。两组患者均未见严重的并发症发生，观察组患者的切口全部甲级愈合，愈合率为100%，对照组患者有3例患者出现切口感染，经过相关处理后，均恢复正常。观察组患者出现并发症2例，对照组患者出现并发症5例，两组患者并发症发生率比较差异无统计学意义（P>0.05）。术后病理回报均为子宫平滑肌瘤。术后随访患者术后1个月复查，此后每6个月随访一次。所有患者均在术后1~3个月恢复正常月经周期，B超检查子宫恢复正常大小。结论：在针对子宫肌瘤患者实施手术时，采用腹腔镜手术，对患者造成的创伤小，大大地减少了患者的痛苦，降低手术后并发症发生的概率，患者恢复更快，值得临床推广应用。
목적：탐토복강경하자궁기류척제술여개복수술적림상치료효과。방법：선취본원2012년12월-2014년12월접수적행실시복강경하자궁기류척제수술적환자35례작위관찰조，령선택본원왕기실시개복수술치료적자궁기류환자36례작위대조조，비교량조환자적수술정황급수술후병발증적발생정황。결과：관찰조례환자균순리완성복강경자궁기류척제술，무일례중전개복。술중환자균미출현부손상、대출혈등병발증。대조조환자수술과정균순리，척제기류개수최다7개，최대직경20 cm，단20 cm기류척제술중실혈량교다，수주홍세포현액2 U。무술중손상，1례술후불전장경조，경보수치료후전유。관찰조환자적수술시간명현장우대조조，수술출혈량급주원비용균명현소우대조조，항문배기시간급주원천수균명현단우대조조，수술절구명현단우대조조，술후진통약물사용솔명현저우대조조，비교차이균유통계학의의（P<0.05）。량조환자균미견엄중적병발증발생，관찰조환자적절구전부갑급유합，유합솔위100%，대조조환자유3례환자출현절구감염，경과상관처리후，균회복정상。관찰조환자출현병발증2례，대조조환자출현병발증5례，량조환자병발증발생솔비교차이무통계학의의（P>0.05）。술후병리회보균위자궁평활기류。술후수방환자술후1개월복사，차후매6개월수방일차。소유환자균재술후1~3개월회복정상월경주기，B초검사자궁회복정상대소。결론：재침대자궁기류환자실시수술시，채용복강경수술，대환자조성적창상소，대대지감소료환자적통고，강저수술후병발증발생적개솔，환자회복경쾌，치득림상추엄응용。
Objective:To investigate the clinical therapeutic effects of laparoscopic myomectomy and abdominal myomectomy.Method:35 patients with laparoscopic myomectomy from December 2012 to December 2014 were selected as the observation group,36 cases of uterine fibroids with open operation treatment in our hospital were selected as the control group.The operation condition and postoperative complications between the two groups were compared.Result:All patients in the observation group were successfully completed laparoscopic myomectomy,no transfer laparotomy.Intraoperative no vice injury occurred,such as bleeding complications.The operation process of control group were all smoothly,eliminated fibroid number up to seven,maximum diameter was 20 cm,but 20 cm fibroids of myomectomy had more blood loss,injected 2 U erythrocyte suspension.No intraoperative injury,1 case of incomplete intestinal obstruction after operation and recovered after conservative treatment.The operation time of the observation group was significantly longer than the control group,operative blood loss and hospitalization expenses were significantly less than the control group,the anus exhaust time and hospitalization days were significantly shorter than the control group, the operative incision was significantly shorter than the control group,the usage rate of postoperative analgesia was significantly lower than the control group,the differences were statistically significant(P<0.05).Two groups of patients were no serious complications occurred,the observation group of patients with all the grade A healing of incision,the healing rate was 100%.In the control group,there were 3 cases with wound infection,after the related treatment,all recovered to normal.There were 2 cases of complications in the observation group,and 5 cases in the control group,there was no statistically significant difference in the complication rate(P>0.05).Postoperative pathological returns were uterine fibroids.The patients were followed up for 1 months after operation and followed up every 6 months.All patients recovered to normal menstrual cycle in 1 month to 3 months after surgery,and the normal size of the uterus was recovered by B ultrasonic examination.Conclusion:For uterine fibroids patients with laparoscopic surgery,with small trauma, greatly reducing the patients’ pain and reduce the probability of postoperative complications,patients recover faster,is worthy of clinical popularization and application.