刘丽霞

【摘要】 目的：比较微创以及開放手术治疗症状性子宫肌瘤对近远期疗效的影响，评价微创技术的应用价值。方法：选取2013年2月-2015年6月医院妇科采用开腹手术子宫肌瘤92例纳入传统组，同期医院采用微创术式治疗的子宫肌瘤患者125例纳入微创组。比较两组患者的手术时间、术中出血量、术后卧床时间、术后恢复进食时间、月经恢复时间、并发症、肌瘤残留、症状控制、复发率。结果：微创组手术时间高于传统组，术中出血量、术后卧床时间、术后恢复进食时间、月经恢复时间、并发症合计发生率低于传统组，两组比较差异均有统计学意义（P<0.05）。两组肌瘤残留、症状控制、复发率比较差异均无统计学意义（P>0.05）。结论：微创手术并不能提高肌瘤剔除、症状控制、预防复发效果，但可减轻创伤，加速患者康复。

【关键词】 微创； 子宫肌瘤； 临床意义

【Abstract】 Objective：To evaluate the efficacy of minimally invasive and open surgery in the treatment of symptomatic uterine fibroids and evaluate the value of minimally invasive technique in the treatment of symptomatic uterine fibroids.Method：From February 2013 to June 2015，the 92 cases of uterine fibroids were treated with open surgery，and 125 patients with uterine myoma were treated by minimally invasive surgery.The operation time，blood volume，postoperative bed time，postoperative recovery time，menstrual recovery time，complications of total incidence，residual myoma，symptom control，and recurrence rate of two groups were compared.Result：The operation time of minimally invasive group was higher than that of the traditional group，blood volume，postoperative bed time，postoperative recovery time，menstrual recovery time，and complications of total incidence in minimally invasive group were lower than those in the traditional group，the differences were statistically significant（P<0.05）.The difference of residual myoma，symptom control，and recurrence rate of two groups were not statistically significant（P>0.05）.Conclusion：Minimally invasive surgery can not improve the effect of myoma rejection，symptom control， or prevention of recurrence，but can reduce the trauma， accelerate the rehabilitation of patients.

【Key words】 Minimally invasive； Uterine fibroids； Clinical significance

First-authors address：Affiliated Zhongshan Hospital of Dalian University，Dalian 116000，China

doi：10.3969/j.issn.1674-4985.2017.04.036

子宫肌瘤是最常见的肿瘤疾病，女性发病率20%～30%，是一种典型的激素依赖性肿瘤，好发于育龄期女性[1]。绝大多数子宫肌瘤无明显症状，有症状患者可出现月经紊乱、腹痛等症状表现，严重者可并发不孕症，特殊情况下子宫肌瘤具有致死性，子宫肌瘤还往往与内异症、子宫粘连等妇科疾病关系密切[2]。有症状子宫肌瘤需及早治疗，治疗方法包括保守以及手术治疗，保守治疗复发率较高、痊愈率难以叫人满意，手术治疗具有一定的创伤性，微创手术越来越受到欢迎[3-5]。临床上对于开放以及微创手术治疗子宫肌瘤的适应证标准尚不明确，一般根据肌瘤位置、大小、数量以及是否合并其他疾病以及治疗目的而定[6]。……