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目的 :腹腔镜子宫肌瘤切除术的手术方法及临床效果总结。方法 :选取2013年9月~2015年10月本院收治的子宫肌瘤患者122例,根据手术方式的不同分为腹腔镜组和开腹组。比较两组患者手术情况、住院时间、住院费用、术后并发症发生率、肌瘤残留和复发率的差异。结果 :腹腔镜组的手术时间高于开腹组,腹腔镜组的术中出血量、术后肛门排气时间、镇痛治疗例数低于开腹组,且差异具有统计学意义。腹腔镜组的住院时间、住院总费用低于开腹组,且差异具有统计学意义。腹腔镜组术后无切口感染和盆腔腹膜炎,发生皮下气肿1例;开腹组术后切口感染2例,盆腔腹膜炎1例,无皮下气肿;两组患者手术并发症发生率(1.49%,5.45%)的差异无统计学意义。术后1个月到2年随访彩超检查发现腹腔镜组2例(2.99%)患者有肌瘤残留,9例(13.43%)患者肌瘤复发;开腹组4例(7.27%)患者有肌瘤残留,13例(23.64%)患者肌瘤复发;两组患者的肌瘤残留和复发率的差异无统计学意义。结论 :腹腔镜下子宫肌瘤切除术手术效果好、住院时间短、住院费用低,且手术并发症和肌瘤残留和复发率与开腹手术比较无显著差异。
Objective: To summarize the surgical methods and clinical effects of laparoscopic myomectomy. Methods: From September 2013 to October 2015, 122 cases of uterine fibroids admitted to our hospital were divided into laparoscopic group and open group according to the different surgical methods. The differences of operation conditions, hospitalization time, hospitalization costs, incidence of postoperative complications, fibroid residue and recurrence were compared between the two groups. Results: The operation time of laparoscopic group was higher than that of laparotomy group. The amount of intraoperative blood loss, time of postoperative anal exhaust and analgesic treatment were lower than those of laparotomy group. The difference was statistically significant. The length of hospital stay and total cost of hospitalization in laparoscopic group were lower than those in open group, and the difference was statistically significant. There was no incision infection and pelvic peritonitis in laparoscopic group, and 1 case developed subcutaneous emphysema. In open group, 2 cases were incisional wound infection and 1 case had pelvic peritonitis without subcutaneous emphysema. The incidence of surgical complications in both groups was 1.49% , 5.45%) the difference was not statistically significant. Two months after operation, follow-up color Doppler ultrasonography showed that there were fibroids in 2 patients (2.99%) in the laparoscopic group and recurrence in 9 patients (13.43%). In the open group, 4 patients (7.27% Thirteen patients (23.64%) had fibroids recurrence. There was no significant difference in fibroid residue and recurrence between the two groups. Conclusions: Laparoscopic myomectomy has good operation effect, short hospital stay and low hospitalization cost. There is no significant difference in operative complications, residual fibroids and recurrence between open surgery and open surgery.