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目的对比分析阴式子宫肌瘤剔除术与经腹子宫肌瘤剔除术治疗子宫肌瘤临床效果。方法 42例子宫肌瘤患者为研究对象,患者要求保留子宫,或因合并内外科疾病不能耐受全子宫切除术,最终选择子宫肌瘤剔除术。所有患者经液基细胞学检查排除宫颈病变,月经异常者行诊断性刮宫并送病理检查排除子宫内膜病变,术前经妇科检查及B超检查,了解子宫大小,子宫肌瘤的大小、数目、生长部位、子宫活动度、阴道是否宽松等,估计可以经阴道及经腹两种不同的手术途径均可以剔除子宫肌瘤。采用计算机随机分组的方式将患者分为对照组和观察组,对照组患者选择经腹子宫肌瘤剔除术,而观察组患者则选择阴式子宫肌瘤剔除术,比较两组患者手术平均时间、术中平均出血量、术后平均住院时间、术后平均首次排气时间和术后镇痛剂使用率。结果在手术平均时间、术中平均出血量、术后平均住院时间、术后平均首次排气时间和术后镇痛剂使用率方面,观察组患者显著少于对照组,差异有统计学意义(P<0.05)。结论阴式子宫肌瘤剔除术是治疗子宫肌瘤一种安全高效的手术方式,值得在临床工作中进一步推广应用。
Objective To compare the clinical effects of vaginal myomectomy and abdominal myomectomy in the treatment of uterine fibroids. Methods Forty-two patients with uterine fibroids were enrolled. Patients were required to retain the uterus or could not tolerate hysterectomy due to combined surgical diseases. The final choice of uterine myomectomy was performed. All patients by liquid-based cytological examination to exclude cervical lesions, menstrual abnormalities were diagnosed curettage and sent to pathological examination to exclude endometrial lesions, preoperative gynecological examination and B-ultrasound to understand the size of the uterus, uterine fibroids size, the number , Growth sites, uterine activity, the vagina is loose, it is estimated that by vaginal and abdominal two different surgical approaches can be removed uterine fibroids. The patients were divided into control group and observation group randomly by computer. The patients in control group were selected for abdominal myomectomy, while those in observation group were vaginal myomectomy. The mean operative time was compared between the two groups. Mean intraoperative bleeding, average postoperative hospital stay, average postoperative first-time deflation, and postoperative analgesic use. Results The average duration of surgery, mean intraoperative blood loss, average postoperative hospital stay, mean postoperative first-time deflation, and postoperative analgesic use were significantly lower in the observation group than in the control group (P < P <0.05). Conclusion Vaginal myomectomy is a safe and effective surgical treatment of uterine fibroids, which is worth further promotion in clinical practice.