经阴道子宫肌瘤剔除术与腹腔镜子宫肌瘤剔除术对比研究

目的探讨经阴道子宫肌瘤剔除术的方法及临床疗效。方法将2009年3月至2011年7月收治的70例子宫肌瘤患者随机分为观察组和对照组,观察组采用经阴道子宫肌瘤剔除术治疗,对照组采用腹腔镜子宫肌瘤剔除术治疗,比较两组的手术效果和术后恢复情况。结果观察组的手术时间和术中出血量少于对照组,剔除肌瘤的数目多于对照组(P<0.05);对照组的术后并发症低于观察组;两组比较差异均有统计学意义(P<0.05)。两组患者在剔除肌瘤的最大直径、术后患者的平均最高体温、平均排气时间和平均术后住院时间相比,无显著差异(P>0.05);两组患者术后均无血肿形成。结论经阴道子宫肌瘤剔除术与腹腔镜剔除术都具有微创和保留生殖功能的特点,经阴道剔除术术中出血少,剔除肌瘤数目较多,但其术后并发症较腹腔镜高,且适应症较为局限。术前要仔细对患者进行评估,依据患者的具体情况选择术式。

Comparison study of transvaginal myomectomy and laparoscopic myomectomy

Objective To investigate the method and clinical curative effect of transvaginal myomectomy. Methods Seventy cases of uterine fibroids treated in our hospital from March 2009 to July 2011 were randomly divided into the observation group and the control group ; the observation group received transvaginal myomectomy, the control group received laparoscopic myomectomy. The operation effect and postoperative recovery were compared between the two groups. Results Operation time and peri - operative bleeding in the observation group were significantly less than the control group （ P 〈 0.05 ）. The number of fibreids removed in the observation group was more than control group （ P 〈 0. 05 ）. However, the incidence of postoperative complications in the control group was significantly lower than the observation group （ P 〈 0.05 ）. There was no significant difference in the largest diameter of the fibroids removed, and postoperative body temperature, exhaust time and hospitalization time （ P 〉 0.05） between the two groups. No hematoma was observed in both groups. Conclusion Both transvaginal myomectomy and laparoscopic myomectomy are minimally invasive and can keep the reproductive function. Compared with laparoscopic myomectomy, the advantages of transvaginal myomectomy are less intraoperative bleeding and more resected fibroids, the disadvantages are higher incidence of postoperative complications and limited indications. The surgery should be selected according, to the specific circumstances of patients.