腹腔镜下子宫肌瘤剔除术与经腹子宫肌瘤剔除术比较及对妊娠结局的影响

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目的比较腹腔镜下子宫肌瘤剔除术与经腹子宫肌瘤剔除术的临床疗效,并分析两种术式对妊娠结局的影响。方法选取新密市妇幼保健院89例子宫肌瘤行手术治疗患者为研究对象,根据手术方式不同分为A、B组,A组46例,B组43例,A组采取腹腔镜下子宫肌瘤剔除术,B组采取经腹子宫肌瘤治疗,比较两组手术时间、肛门排气时间、住院时间、术中出血量,并随访观察两组妊娠结局、复发率及并发症发生情况。结果 A组手术时间显著高于B组,肛门排气时间、住院时间、术中出血量分别为(1.26±0.58)d、(3.64±1.25)d、(51.36±3.14)ml,较B组(2.97±1.05)d、(4.95±1.33)d、(97.58±7.64)ml显著较低(P<0.05);A组术后妊娠率、术后流产率、术后自然流产及复发率与B组比较差异未见统计学意义(P>0.05);A组1例术后尿频,B组1例切口感染,2例腹痛,1例尿频,两组术后并发症比较差异未见统计学意义(χ2=2.130,P<0.05)。结论腹腔镜下子宫肌瘤剔除术与经腹子宫肌瘤剔除术治疗子宫肌瘤均有一定疗效,腹腔镜手术时间较开腹手术较长,但出血及术后康复优于开腹手术,两种手术妊娠率及复发率比较差异未见统计学意义。 Objective To compare the clinical efficacy of laparoscopic myomectomy and abdominal myomectomy, and analyze the effect of the two surgical procedures on pregnancy outcome. Methods 89 cases of uterine fibroids in Xinmi MCH hospital underwent surgical treatment. The patients were divided into A group and B group according to the operation method. 46 cases in group A and 43 cases in group B received laparoscopic uterine muscle Tumor resection in group B was treated by transcervical uterine fibroids. The operation time, anal exhaust time, hospitalization time and blood loss were compared between two groups. The pregnancy outcome, recurrence rate and complications were observed. Results The operative time of group A was significantly higher than that of group B, and the time of anus discharge, hospital stay and blood loss were (1.26 ± 0.58) d, (3.64 ± 1.25) d and (51.36 ± 3.14) ml respectively, 2.97 ± 1.05 d, 4.95 ± 1.33 d and 97.58 ± 7.64 ml respectively (P <0.05). The postoperative pregnancy rate, postoperative abortion rate, postoperative spontaneous abortion and recurrence rate in group A were significantly lower than those in group B There was no significant difference between the two groups (P> 0.05). One case of group A had frequent urination after operation, one case of incision infection in group B, two cases of abdominal pain and one case of frequent urination. There was no significant difference in postoperative complications χ2 = 2.130, P <0.05). Conclusions Laparoscopic myomectomy and abdominal myomectomy for the treatment of uterine fibroids have a certain effect, laparoscopic surgery time is longer than open surgery, but bleeding and postoperative recovery is better than open surgery, two The surgical pregnancy rate and recurrence rate difference was not statistically significant.
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