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目的:探讨单发子宫肌瘤患者实施子宫肌瘤剔除术的最佳术式。方法:单发子宫肌瘤病例58例随机分为开腹子宫肌瘤剔除术组和腹腔镜子宫肌瘤剔除术组,出院后随访3年,分析两组间手术时间、术中出血量、住院时间、出院后是否受孕、是否复发以及复发时间等指标。结果:所有病例均成功手术,腹腔镜组与开腹组手术时间分别为(105.0±12.7)min和(44.7±10.9)min,术中出血量分别为(108.0±18.0)ml和(46.3±6.3)ml,术后住院时间分别为(4.3±0.59)天和(6.5±0.89)天。两组病例住院期间均无明显手术并发症,出院后3年内有11例患者复发,其中腹腔镜组6例,开腹组5例,复发率分别为20.7%和17.2%,无1例在随访期间实施再次手术,两组中有妊娠意愿的患者分别有10例和12例,术后3年内分别有7例和3例成功受孕,受孕率分别为70.0%和25.0%。结论:对于单发子宫肌瘤患者,两种术式均能得以成功实施,术后复发率无明显差异,对于有妊娠意愿的患者腹腔镜子宫肌瘤剔除术是较好的选择。
Objective: To investigate the best technique of myomectomy in patients with single myoma of uterus. Methods: Fifty-eight cases of single myoma of uterus were randomly divided into open laparoscopic myomectomy group and laparoscopic myomectomy group. All patients were followed up for 3 years after discharge. The operation time, intraoperative blood loss, hospitalization Time, conception after discharge, recurrence and recurrence time and other indicators. Results: The operation time was (105.0 ± 12.7) min and (44.7 ± 10.9) min in laparoscopic group and open group respectively. The blood loss in operation was (108.0 ± 18.0) ml and (46.3 ± 6.3) ) ml, postoperative hospital stay were (4.3 ± 0.59) days and (6.5 ± 0.89) days, respectively. There was no obvious complication during hospitalization in both groups. In the 3 years after discharge, 11 patients relapsed, including 6 in laparoscopic group and 5 in open group. The recurrence rates were 20.7% and 17.2% respectively. None of the patients were followed up During the reoperation, 10 and 12 patients, respectively, had the intention of pregnancy in both groups. After 3 years of operation, 7 patients and 3 patients achieved conception successfully. The pregnancy rates were 70.0% and 25.0% respectively. Conclusion: For the patients with single myoma of uterus, both procedures can be successfully implemented. There is no significant difference in the recurrence rate after operation. Laparoscopic myomectomy is the best choice for patients with pregnancy intention.