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目的分析腹腔镜肌瘤剔除术治疗子宫肌瘤患者的疗效以及对预后的影响。方法 53例采取开腹肌瘤剔除术(AM)治疗的子宫肌瘤患者作为开腹组,62例采取腹腔镜肌瘤剔除术(LM)治疗的子宫肌瘤患者作为腹腔镜组,对比两组术中、术后指标,随访18个月评估患者复发率及预后生活质量评分。结果腹腔镜组患者手术时间为(60.19±4.96)min,术中出血量为(88.38±7.29)ml、术后排气时间为(20.47±4.97)h,住院天数为(3.95±1.18)d均优于开腹组患者的(73.62±7.83)min、(132.90±16.0)ml、(36.67±4.84)h、(8.05±1.35)d,差异均具有统计学意义(P<0.05)。腹腔镜组术后创口感染发生率为16.13%,术后镇痛率为30.65%,术后发热率为11.29%;开腹组术后创口感染发生率为58.49%,术后镇痛率为77.36%,术后发热率为52.83%;腹腔镜组三组指标均显著优于开腹组,差异有统计学意义(P<0.05)。腹腔镜组术后1个月肌瘤残留率1.61%,术后12个月肌瘤复发率3.23%,术后18个月生活质量评分为(90.67±4.51)分优于开腹组的13.21%、16.98%、(86.48±7.26)分,差异有统计学意义(P<0.05)。结论 LM治疗子宫肌瘤疗效确切、安全可靠,且具有手术创口小、术后易恢复及不易复发的明显优势,可于子宫肌瘤的手术治疗中推广应用。
Objective To analyze the efficacy of laparoscopic myomectomy in the treatment of patients with uterine fibroids and prognosis. Methods Totally 53 cases of uterine leiomyoma treated by open myomectomy (AM) were treated as open group and 62 cases of uterine leiomyoma treated with laparoscopic myomectomy (LM) as laparoscopic group. Intraoperative and postoperative indexes were followed up for 18 months to evaluate the relapse rate and quality of life of patients. Results The operation time of laparoscopic group was (60.19 ± 4.96) min, the volume of bleeding during operation was (88.38 ± 7.29) ml, the duration of postoperative gas exhaust was (20.47 ± 4.97) h and the length of hospitalization was (3.95 ± 1.18) d (73.62 ± 7.83) min, (132.90 ± 16.0) ml and (36.67 ± 4.84) h and (8.05 ± 1.35) d respectively in open group. The difference was statistically significant (P <0.05). The incidence of wound infection in laparoscopic group was 16.13%, the postoperative analgesic rate was 30.65% and the postoperative fever rate was 11.29%. The incidence of wound infection in open group was 58.49% and the postoperative analgesic rate was 77.36 %, Postoperative fever rate was 52.83%; laparoscopic group three indicators were significantly better than the open group, the difference was statistically significant (P <0.05). The residual rate of fibroids was 1.61% at 1 month after operation in laparoscopic group, 3.23% at 12 months after operation, and the quality of life score at 18 months after operation was (90.67 ± 4.51) than 13.21% , 16.98%, (86.48 ± 7.26) points, the difference was statistically significant (P <0.05). Conclusion LM treatment of uterine fibroids curative effect is exact, safe and reliable, and has the advantages of small surgical wounds, easy recovery and easy recurrence, which can be widely used in the surgical treatment of uterine fibroids.