【摘要】 目的比较腹腔镜下子宫肌瘤剔除术(Laparoscopic myomectomy,LM)、经阴道子宫肌瘤剔除术(Transvaginalmyomectomy,TVM)和经腹子宫肌瘤剔除术(Transabdominal myomectomy,TAM)的临床特点,探讨3种术式的利弊。方法回顾性分析2010年7月～2011年10月于天津市中心妇产科医院行子宫肌瘤剔除术患者的临床资料,其中LM组65例,TVM组50例,TAM组75例,对三组患者术中及术后临床指标进行比较。结果 LM组手术时间、住院费用均高于TVM组、TAM组(P<0.05),后两组比较差异无统计学意义(P>0.05);术中出血量、血红蛋白下降程度、术后住院时间及术后镇痛率为LM组<TVM组<TAM组,3组任意两组比较差异均有统计学意义(P<0.05);肌瘤数目、术后排气时间TAM组均明显多于LM组与TVM组(P<0.05),后两组比较差异无统计学意义(P>0.05);术后病率LM组明显低于TAM组(P<0.05),TVM组与TAM组差异无统计学意义(P>0.05)。结论 LM术式和TVM术式均具有微创手术的诸多优越性,但也存在一定的局限性。传统TAM术式适应证最广泛,医生应根据患者的临床特征个体化选择治疗方式。更多还原

【Abstract】 Objective To compare clinical characteristics in laparoscopic myomectomy,transvaginal myomectomy and transabdominal myomectomy,and to discuss the advantages and disadvantages of the three kinds of operation.Methods From July 2010to October 2011,65 cases of LM,50 cases of TVM and 75 cases of TAM were studied retrospectively in Tianjin central obstetrics and gynecology hospital,the effects of operation and recovery of three groups were compared before and after operation.Results 0perative time and hospitalization cost in LM were much more than TVM and TAM(P<0.05),there were no statistically significant differences in the latter two P>0.05).The blood loss,the decrease of hemoglobin,the postoperative hospital stay days and postoperative analgesic rate in TAM group were significantly greater than those in TVM or LM(P<0.05),there were statistically significant differences in the latter two(P<0.05).The number of fibroids removed and the postoperative exhaust time in TAM were much more than TVM and LM(P<0.05),there were no statistically significant differences in the latter two(P>0.05).Postoperative morbidity in LM was significantly lower than TAM(P<0.05),there was no statistically significant difference between TVM and TAM(P>0.05).Conclusion Both LM and TVM have many advantages of microsurgery,but have some limitations,TAM has the most extensive adaptation disease.Treatment should be selected according to individual patients.更多还原