摘要
目的分析腹腔镜下特殊部位子宫肌瘤剔除术的可行性与安全性。方法比较56例腹腔镜下特殊部位子宫肌瘤剔除(腹腔镜组)和67例经腹特殊部位子宫肌瘤剔除(经腹组)的术中出血量、手术时间、术后肛门排气时间、术后住院时间、术后血红蛋白下降量、术后病率、术后2年随访复发病人数等指标。结果经腹组手术均顺利完成。腹腔镜组56例中1例因盆腔粘连严重及肌瘤剔除后瘤腔缝合后仍出血不止而中转开腹,手术成功率达98.21%。2组术中出血量、手术时间、术后肛门排气时间、术后住院时间、术后血红蛋白下降量、术后病率、术后2年随访复发病人数,腹腔镜组分别为(57.50±45.34)m L、(85.82±32.15)min、(18.79±2.63)h、(3.54±1.04)d、(19.08±10.09)g·L-1、(37.47±0.47)℃、(7/56,12.50%);经腹组分别为(81.34±41.09)m L、(65.18±23.74)min、(24.72±2.70)h、(4.45±0.97)d、(38.53±9.64)g·L-1、(38.06±0.47)℃、(5/67,7.46%)。2组患者的术中出血量、手术时间、术后肛门排气时间、术后住院时间、术后血红蛋白下降量、术后病率,差异均有统计学意义(P<0.05)。术后2年随访复发病人数,差异无统计学意义(P>0.05)。结论腹腔镜在特殊部位子宫肌瘤剔除术中较传统手术更安全,具有可行性,可以广泛推广。
Objective To analyze the feasibility and safety of special positions of laparoscopic myomectomy. Methods A total of 123 patients with special site uterine myoma were marked out two groups： Laparoscopic group（Laparoscopic myomectomy,n = 56）and abdominal group（Abdominal myomectomy,n = 67）. The blood lose in operation,operation duration,postoperative anal exhaust time,postoperative hospital stays,postoperative hemoglobin decreased amount,postoperative morbidity and the number of relapsed patients after operations during the two- year follow- up were observed and compared. Results Operations in abdominal group were completed smoothly. In laparoscopic group,55 cases were successfully completed in laparoscopy,one case was converted to laparotomy due to pelvic adhesions and still bleeding after myoma was removed and the tumor cavity was sutured,operative success rate was 98. 21%.Laparoscopic group： the blood lose in operation（57. 50 ± 45. 34） m L,operation duration（85. 82 ± 32. 15） min,postoperative anal exhaust time（18. 79 ± 2. 63） h,postoperative hospital stays（3. 54 ± 1. 04） d,postoperative hemoglobin decreased amount（19. 08 ±10. 09） g·L^-1,postoperative morbidity（37. 47 ± 0. 47） ℃ and the number of relapsed patients after operations during the two- year follow- up（7 /56,12. 50%）; abdominal group：（81. 34 ± 41. 09） m L,（65. 18 ± 23. 74） min,（24. 72 ± 2. 70） h,（4. 45 ± 0. 97） d,（38. 53 ± 9. 64） g·L^-1,（38. 06 ± 0. 47） ℃,（5 /67,7. 46%）. There were significantly differences between blood lose in operation,operation duration,postoperative anal exhaust time,postoperative hospital stays,postoperative hemoglobin decreased amount,postoperative morbidity（P〈0. 05）. The number of relapsed patients after operations during the two- year following- up had no significant difference between two groups（P〉0. 05）. Conclusion Compared with the traditional operation,laparoscopic surgery in special positions of uterine myomectomy may be safe
出处
《宁夏医学杂志》
CAS
2015年第9期802-804,共3页
Ningxia Medical Journal
