腹腔镜子宫肌瘤剔除术的临床研究.doc

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1、腹腔镜子宫肌瘤剔除术的临床研究　【摘要】目的：探讨腹腔镜下子宫肌瘤剔除术和腹腔镜辅助下子宫肌瘤剔除术的手术方法、技巧、术后疗效及临床应用价值。方法：回顾对比分析腹腔镜子宫肌瘤剔除术103例(A组)与开腹子宫肌瘤剔除术100例(B组)，腹腔镜辅助下子宫肌瘤剔除术18例(C组)与开腹子宫肌瘤剔除术20例(D组)的手术方法和术中术后各临床指标。结果：腹腔镜组（A组）与对照组（B组）平均手术时间无明显差异（Ｐ＞005)；术中平均出血量，术后体温恢复时间，术后肛门排气时间，术后病率，术后住院时间均有明显差异（Ｐ＜001）。腹腔镜辅助组（C组）与对

2、照组（D组）平均手术时间，术中平均出血量无明显差异（Ｐ＞005)；术后体温恢复时间，术后肛门排气时间，术后病率，术后住院时间均有显著差异（Ｐ＜001）。结论：腹腔镜和腹腔镜辅助下子宫肌瘤剔除术具有创伤小、术中出血少、术后恢复快及住院时间短的优势，子宫肌瘤的腹腔镜手术无疑是一种保留器官的理性术式，随着腹腔镜手术技巧的提高和器械的更新改进，子宫肌瘤的腹腔镜保守手术将有更广阔的临床应用前景。　　【关键词】腹腔镜；子宫肌瘤剔除术　　Theclinicalstudyoflaparoscopichysteromyomectomy　　【Abstrac

3、t】Ｏbjective:Todiscusstheoperativemethodandskill,postoperativecurativeeffectandclinicalvalueoflaparoscopichysteromyomectomyandlaparoscopicaccessorialhysteromyomectomy.Methods:Theretrospectiveanalysisandcomparisonweremadeontheoperativemethodandtheclinicalindexofintraoperat

4、ion,postoperationbetween103casesunderwentlaparoscopichysteromyomectomy(Agroup)and100casesunderwentlaparotomyhysteromyomectomy(Bgroup),alsobetween18casesunderwentlaparoscopeaccessorialhysteromyomectomy(Cgroup)and20casesunderwentlaparotomyhysteromyomectomy(Dgroup).Results:

5、TherewasnodifferenceinthemeanoperativetimebetweenAgroupandBgroup(Ｐ＞005),butthereweresignificantdifference(Ｐ＜001)betweenAgroupandBgroupinthemeanoperativebloodloss.Themeanbodytemperaturerecoverytimepostoperativeblindenematime,therateofpostoperativecomplicatingdiseaseandthe

6、meanhospitalization.BetweenCgroupandDgroup,therewerenosignificantdifference(Ｐ＞005)inthemeanoperativetimeandthemeanoperativebloodloss,butthereweresignificantdifferenceinthetemperaturerecoverytime,thepostoperativeblindenematime,therateofpostoperativecomplicatingdiseaseandt

7、hemeanhospitalization.Conclusions:Thelaparoscopichysteromyomectomyistheidealprocedureforretainingorgans,withtheadvantagesofminimalinvision,lessoperativebloodloss,quickrecoveryandshorthospitalization.4　　【Keywords】Laparoscopy；Hysteromyomectomy　　子宫肌瘤是女性生殖器官中最常见的良性肿瘤，子宫肌瘤剔除术

8、主要有开腹和腹腔镜、腹腔镜辅助下子宫肌瘤剔除术。腹腔镜和腹腔镜辅助子宫肌瘤剔除术具有创伤小、出血少、恢复快的优点，已逐步替代开腹手术。现将我院2002～2006年行腹腔镜子宫肌瘤剔除手术103例和腹腔镜辅助