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目的:探讨阴式和腹腔镜下子宫肌瘤剔除术的微创价值。方法:选择2006年6月~2008年10月阴式子宫肌瘤剔除术患者45例(阴式组)及同期行腹腔镜子宫肌瘤剔除术的患者45例(腹腔镜组)和腹式子宫肌瘤剔除术50例(腹式组)患者的临床资料,比较3组的手术时间、术中出血量、术后体温恢复正常时间、术后排气时间和术后住院时间、术后病率。结果:阴式组手术时间最短,开腹组手术时间与腹腔镜组比较差异无统计学意义(P>0.05);术中出血量阴式组最少,腹腔镜组次之,且均少于开腹组(P<0.05);术后体温恢复正常时间阴式组与腹腔镜组比较差异无统计学意义(P>0.05),均短于开腹组;术后排气时间阴式组最短,腹腔镜组次之,均短于开腹组;术后住院时间阴式组与腹腔镜组比较差异无统计学意义(P>0.05),均短于开腹手术组(P<0.05)。术后病率比较中,差异无统计学意义(P>0.05)。结论:腹腔镜下和经阴道子宫肌瘤剔除术与经腹子宫肌瘤剔除术相比具有创伤小、术中出血少、术后恢复快及住院时间短等优点,阴式子宫肌瘤剔除术经过改变术前阴道消毒方法后术后病率、盆腔感染率显著下降,是值得推广和应用的微创术式。
Objective: To explore the minimally invasive value of vaginal and laparoscopic myomectomy. Methods: Forty-five patients (negative group) and 45 patients (laparoscopic group) undergoing laparoscopic myomectomy at the same period from June 2006 to October 2008 underwent vaginal myomectomy and abdominal uterus 50 patients with myomectomy (abdominal group), clinical data were compared between the three groups of operation time, intraoperative blood loss, postoperative body temperature recovery time, postoperative exhaust time and postoperative hospital stay, postoperative morbidity . Results: The operation time of the vaginal group was the shortest, there was no significant difference between open group and laparoscopic group (P> 0.05); the amount of bleeding in the vaginal group was the least, followed by the laparoscopic group less than (P <0.05). There was no significant difference between the laparoscopic group and the vaginal group (P> 0.05), which were shorter than that of the laparotomy group. The shortest postoperative exhaust time was in the vaginal group, Laparoscopic group followed, were shorter than the open group; postoperative hospital stay was no significant difference between vaginal group and laparoscopic group (P> 0.05), were shorter than the open surgery group (P <0.05). There was no significant difference in postoperative morbidity (P> 0.05). Conclusion: Laparoscopic and transvaginal myomectomy and transabdominal myomectomy compared with less trauma, less bleeding, postoperative recovery and shorter hospital stay, etc., vaginal myomectomy After the change of preoperative vaginal disinfection method postoperative morbidity, pelvic infection was significantly decreased, it is worth to promote and application of minimally invasive surgery.