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目的探讨比较子宫壁间肌瘤行宫腔镜电切术与腹腔镜剔除术的效果。方法以本院2012年1月—2014年12月间收治的86例子宫壁间肌瘤患者为研究对象,采用随机数字表法分为宫腔镜组和腹腔镜组各43例,分别行宫腔镜下子宫肌瘤电切术和腹腔镜下子宫肌瘤剔除术,比较两组手术相关指标,随访6个月观察肌层愈合情况。计量资料采用t检验,计数资料采用χ~2检验,P<0.05为差异有统计学意义。结果宫腔镜组患者术中出血量为(62.5±6.0)ml、手术时间为(43.26±21.79)min、术后排气时间为(22.6±3.5)h,腹腔镜组患者术中出血量为(117.4±10.3)ml、手术时间为(87.29±25.09)min、术后排气时间(34.5±4.3)h,宫腔镜组患者相关指标比较方面均优于腹腔镜组,对比差异均有统计学意义(均P<0.05)。腹腔镜组患者术中转开腹率为2.33%、术后月经改善率为95.35%、发热率为6.98%,腹腔镜组患者术中转开腹率为0.0%、术后月经改善率为97.68%、发热率为2.33%,两组对比差异均无统计学意义(均P>0.05),随访6个月,宫腔镜组患者术后1、3、6个月肌层完全愈合率均高于腹腔镜组(34.88%、69.77%、100.00%、9.30%、41.86%、74.42%),对比差异均有统计学意义(均P<0.05)。结论子宫壁间肌瘤治疗中应用宫腔镜电切术与腹腔镜剔除术均有较好效果,且从整体上来看,宫腔镜手术优于腹腔镜,值得临床推广应用。
Objective To compare the results of hysteroscopic resection and laparoscopic resection of uterine fibroids. Methods A total of 86 patients with uterine fibroids treated in our hospital from January 2012 to December 2014 were selected as study subjects and divided into hysteroscopy group and laparoscopic group by random number table. Microscopic myomectomy and laparoscopic myomectomy, compared the operation-related indicators of the two groups, followed up for 6 months to observe the healing of myometrial. Measurement data using t test, count data using χ ~ 2 test, P <0.05 for the difference was statistically significant. Results The bleeding volume of the hysteroscopy group was (62.5 ± 6.0) ml, the operation time was (43.26 ± 21.79) min and the duration of postoperative bleeding was (22.6 ± 3.5) h. The intraoperative blood loss in the laparoscopic group was (117.4 ± 10.3) ml, the operative time was (87.29 ± 25.09) min and the time of postoperative exhaust (34.5 ± 4.3) h, respectively, which were better than that of the laparoscopic group Significance (both P <0.05). In laparoscopic group, the rate of laparotomy was 2.33%, the rate of postoperative menstruation was 95.35%, the rate of fever was 6.98%, the rate of laparotomy was 0.0%, the rate of postoperative menstrual improvement was 97.68% The fever rate was 2.33%, there was no significant difference between the two groups (all P> 0.05). After 6 months of follow-up, the complete healing rate of myometrium in hysteroscopic group was higher than that in abdominal cavity (34.88%, 69.77%, 100.00%, 9.30%, 41.86%, 74.42%), the difference was statistically significant (all P <0.05). Conclusion The application of hysteroscopic resection and laparoscopic resection in the treatment of uterine fibroids have a good effect, and on the whole, hysteroscopic surgery is better than laparoscopy, it is worthy of clinical promotion and application.