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目的比较经腹或经阴道剔除术对子宫肌瘤治疗的临床效果,为临床治疗术式的选择提供一定的参考依据。方法选取2011年7月—2015年7月妇科收治的子宫肌瘤患者418例,根据手术方法不同将患者分为2组,其中观察组208例,行经阴道子宫肌瘤剔除术治疗,对照组210例,行经腹子宫肌瘤剔除术治疗。观察2组患者手术时间、术中出血量、剔除肿瘤平均直径、剔除肿瘤平均重量、肛门排气时间、住院时间及术后恢复情况。结果2组患者手术时间差异无统计学意义(P>0.05);而观察组的术中出血量、肛门排气时间、住院时间明显小于对照组,差异具有统计学意义(P<0.05);观察组和对照组剔除肿瘤平均直径和平均重量、子宫肌瘤数目方面差异均无统计学意义(P>0.05),说明经阴道剔除术剔除肿瘤的效果和经腹剔除术基本相同。在随访过程中,2组患者术后的临床症状均已完全缓解,但观察组患者影响性生活例数略高于对照组,观察组患者术后开始正常工作时间明显小于对照组,比较差异具有统计学意义(P<0.05)。结论经阴道子宫肌瘤剔除术具有创伤更小、患者术后恢复时间更短、无疤痕腹壁、住院时间短、患者恢复正常工作时间更快等优点,微创理念显著,因此需要临床医师严格按照子宫肌瘤的绝对适应证的前提下,在术前确定掌握子宫肌瘤部位、数量、大小直径和子宫的活动程度,然后进行个体性方法的选择,提高患者术后整体临床疗效。
Objective To compare the clinical effects of transabdominal or transvaginal excision on the treatment of uterine fibroids and to provide some references for the choice of clinical treatment. Methods 418 cases of uterine myoma treated by gynecology from July 2011 to July 2015 were selected. The patients were divided into two groups according to different surgical methods, including 208 cases in the observation group and vaginal myomectomy. The control group 210 Cases, the line of abdominal myomectomy surgery. The operation time, intraoperative blood loss, mean tumor diameter, mean tumor weight, anal exhaust time, hospital stay and postoperative recovery were observed. Results There was no significant difference in operative time between the two groups (P> 0.05). The intraoperative blood loss, anal exhaust time and hospital stay in the observation group were significantly lower than those in the control group (P <0.05) There was no significant difference in the mean diameter and average weight of tumor and the number of uterine fibroids between the two groups (P> 0.05), which showed that the curative effect of transurethral resection was almost the same as that of transabdominal resection. During the follow-up, the clinical symptoms of the two groups of patients were completely relieved, but the number of life-affecting cases in the observation group was slightly higher than that in the control group. The observation group had significantly less postoperative normal working hours than the control group, Statistical significance (P <0.05). Conclusion Transvaginal myomectomy has the advantages of less trauma, shorter postoperative recovery time, no scar abdominal wall, shorter hospital stay time and faster recovery time of patients. The concept of minimally invasive surgery is obvious, and clinicians need to strictly follow the Uterine fibroids on the premise of the absolute indications, to determine the preoperative grasp of uterine fibroids parts, the number, size, diameter and uterine activity, and then the choice of individual methods to improve the overall postoperative clinical efficacy.