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目的探讨三种不同手术方式治疗Ⅱ型黏膜下子宫肌瘤的效果、术式特点及适应证对比分析。方法收集我院2015年1月~2016年10月收治的118例Ⅱ型黏膜下子宫肌瘤患者作为研究对象,按患者入院时间顺序,将患者分为宫腔镜组(n=31)、腹腔镜组(n=45)、开腹组(n=42),比较三组患者术中出血量、手术时间及并发症情况,分析手术特点及适应证。结果宫腔镜组及腹腔镜组在同组肌瘤大小患者中,肌瘤≥5mm患者的手术时间最长,术中出血量最高(P<0.05);三组相同肌瘤大小患者手术时间、术中出血量均有差异(P<0.05)。结论宫腔镜下电切术治疗Ⅱ型黏膜下肌瘤是治疗黏膜下子宫肌瘤首选,肌瘤直径大于≥5mm的患者采用腹腔镜进行治疗较为安全,多发性肌瘤可选择开腹手术减少复发率和残留率。
Objective To investigate the effect of three different surgical methods on the treatment of type Ⅱ submucosal uterine fibroids, the characteristics of surgical procedures and the comparative analysis of indications. Methods A total of 118 patients with type Ⅱ submucosal fibroids who were admitted to our hospital from January 2015 to October 2016 were enrolled in this study. Patients were divided into hysteroscopy group (n = 31), abdominal cavity (N = 45) and open group (n = 42). The blood loss, operation time and complications of the three groups were compared. The operation characteristics and indications were analyzed. Results Hysteroscopy group and laparoscopic group in the same group of fibroids size patients, fibroids ≥ 5mm patients had the longest operation time, the highest amount of bleeding during operation (P <0.05); three groups of patients with the same size of fibroids surgery time, Intraoperative bleeding were different (P <0.05). Conclusion hysteroscopic resection of type Ⅱ submucosal fibroids is the treatment of choice for submucous uterine fibroids, fibroids larger than 5mm in patients with laparoscopic treatment of safer, multiple fibroids can choose to open surgery to reduce Recurrence rate and residual rate.