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目的探讨不同手术方式对子宫肌瘤的机体创伤及安全性。方法选取126例子宫肌瘤患者,按照手术方式的不同分为对照组和治疗组,各63例。对照组患者采用传统开腹手术,治疗组患者采用腹腔镜下子宫肌瘤切除术。观察两组患者的术后恢复、疼痛和不良反应情况,并观察术后瘤体体积变化情况。结果两组患者治疗后一般状况良好,但治疗组患者术后住院时间为(3.4±1.6)d,下床时间为(1.3±0.6)h,阴道出血时间为(3.1±0.9)d,均显著短于对照组的(7.3±1.7)d,(46.8±11.2)h,(11.7±5.3)d,差异均有统计学意义(均P<0.05);治疗组患者术后6 h和24 h疼痛评分均显著优于对照组,差异均有统计学意义(均P<0.05);但术后72 h疼痛评分在各组间差异均无统计学意义(均P>0.05);治疗组术后的不良反应发生率为23.8%,显著少于对照组的49.2%,差异有统计学意义(P<0.05);术后随访6个月发现,治疗组的瘤体体积显著缩小,但对照组部分患者仍发现瘤体的增长。结论尽管腹腔镜下子宫肌瘤切除术未完全切除瘤体,但整体上改变了瘤体的大小,且术后患者恢复快,创伤小,安全性高,值得临床进一步推广。
Objective To investigate the surgical trauma and safety of uterine fibroids in different surgical methods. Methods 126 cases of uterine fibroids were selected, divided into control group and treatment group according to the different surgical methods, each 63 cases. The control group of patients with the traditional open surgery, the treatment group patients with laparoscopic myomectomy. The postoperative recovery, pain and adverse reactions of the two groups were observed, and the changes of tumor volume after operation were observed. Results The two groups were generally in good condition after treatment, but the postoperative hospital stay time was (3.4 ± 1.6) days, the time to bed was (1.3 ± 0.6) hours and the vaginal bleeding time was (3.1 ± 0.9) days in both groups (7.3 ± 1.7) days, (46.8 ± 11.2) days and (11.7 ± 5.3) days in the control group were significantly shorter than those in the control group (all P <0.05) (All P <0.05). However, there was no significant difference in the score of pain between the two groups at 72 h postoperatively (all P> 0.05). After the operation, The incidence of adverse reactions was 23.8%, significantly less than 49.2% in the control group, the difference was statistically significant (P <0.05); after 6 months of follow-up, the tumor volume of the treatment group was significantly reduced, but some patients in the control group Still found that the growth of the tumor. Conclusion Although laparoscopic myomectomy did not completely remove the tumor, it changed the size of the tumor as a whole, and patients recovered faster, less trauma and higher safety after operation. It is worth further clinical promotion.