陈欣

[摘要] 目的 探讨比较腹腔镜子宫肌瘤剔除术与经腹子宫肌瘤剔除术治疗子宫肌瘤的临床效果。 方法 回顾性分析四川省绵阳市人民医院2014年5月～2016年5月收治的子宫肌瘤患者90例的临床资料，依据手术治疗措施的不同分为经腹组（40例）和腹腔镜组（50例）。经腹组行经腹子宫肌瘤剔除术，腹腔镜组行腹腔镜子宫肌瘤剔除术。观察两组患者术中出血量、手术时间、术后住院天数、术后并发症（感染、切口出血、肠梗阻、气肿）和术后月经恢复及肌瘤复发情况。 结果 腹腔镜组术中出血量、手术时间、术后住院天数均少于或短于经腹组，腹腔镜组术后并发症发生率明显低于经腹组，差异均有统计学意义（P < 0.05）。两组术后月经恢复比例、肌瘤复发比例比较，差异均无统计学意义（P > 0.05）。 结论 腹腔镜子宫肌瘤剔除术治疗子宫肌瘤创伤小，恢复快，术后并发症少，值得临床推广应用。

[关键词] 腹腔镜子宫肌瘤剔除术；经腹子宫肌瘤剔除术；子宫肌瘤；并发症

[中图分类号] R711.74 [文献标识码] A [文章编号] 1673-7210（2017）05（b）-0088-04

[Abstract] Objective To investigate and compare the clinical effect of laparoscopic myomectomy and trans-abdominal myomectomy in the treatment of uterine fibroid. Methods The clinical data of 90 cases of patients with uterine fibroid admitted to Mianyang People's Hospital of Sichuan province from May 2014 to May 2016 was analyzed retrospectively， the patients were divided into trans-abdominal group （40 cases） and laparoscopic group （50 cases）. The trans-abdominal group was taken trans-abdominal myomectomy， the laparoscopic group was taken laparoscopic myomectomy. The intraoperative blood loss， operation time， postoperative hospital stay， postoperative complications （infection， bleeding of incisions， intestinal obstruction， emphysema） and the conditions of recovery of menstruation， recurrence of uterine fibroid of two groups were observed. Results The intraoperative blood loss， operation time， postoperative hospital stay of laparoscopic group were less or shorter than those of trans-abdominal group， the incidence of postoperative complications in laparoscopic group was lower than that of trans-abdominal group， the differences were all statistically significant （P < 0.05）. There were no statistically significant differences of the proportion of recovery of menstruation and recurrence of uterine fibroidb between the two groups （P > 0.05）. Conclusion Laparoscopic myomectomy in the treatment of uterine fibroid has little trauma， fast recovery and less postoperative complications， which is worthy of clinical promotion and application.

[Key words] Laparoscopic myomectomy； Trans-abdominal myomectomy； Uterine fibroid； Complication

子宮肌瘤属于女性生殖系统常见的良性肿瘤，其主要是由于子宫平滑肌细胞发生增生造成的，在育龄妇女中，子宫肌瘤发生率为20%左右[1-2]，其主要的临床表现是月经周期延长或者缩短、下腹部会出现包块、排尿或者排便困难[3-4]。随着微创技术在妇产科中的广泛应用，腹腔镜下子宫肌瘤剔除术在临床中的应用率也呈现明显升高趋势，其具有创伤小、出血少的特点，有利于患者术后恢复[5-6]。本研究分析90例子宫肌瘤患者的临床资料，将结果汇报如下：

1 资料与方法