目的 探讨阴式子宫肌瘤剥除术的临床效果和安全性.方法 回顾性分析阴式子宫肌瘤剔除术患者40例(阴式组),同期腹腔镜下子宫肌瘤剔除术43例(腹腔镜组),开腹子宫肌瘤剔除术29例(开腹组)患者的临床资料,比较手术效果和术后恢复情况.结果 所有手术均顺利完成.与开腹组相比,阴式组的术中出血量少、术后排气时间早、术后最高体温低、下床活动早、住院时间短、术后镇痛率低(P<0.05);腹腔镜组的手术时间和住院时间短、术后镇痛率低,但医疗费用较高(P<0.05);而阴式组与腹腔镜组相比,阴式组的手术时间短、术中出血量少,且医疗费用较低(P<0.05);余各指标组间无统计学差异(P>0.05).结论 阴式子宫肌瘤剔除术安全、有效、创伤小、术后疼痛轻、并发症少、恢复快,医疗费用低,是一种值得推广的微创手术.%Objective To evaluate the feasibility, clinical effect and safety of transvaginal myomectomy (TVM). Method Retrospective study was done in 40 cases of TVM, 43 cases of laparoscopic myomectomy(LM) and 29 cases of transabdominal myomectomy(TAM). Results Comparing with TAM group, it showed significant dominance of the TVM in the intraoperative hemorrhage, the postoperative evacuating time, the postoperative highest body temperature, the off-bed time, the hospital stay, and the analgesia rate ( P ＜ 0.05 ). And also comparing with TAM group, it showed significant dominance of the LM in the operation time and the hospital stay, and obvious shortage of the higher medical care costs (P ＜ 0.05 ). While comparing to the LM group, the TVM group demonstrated less operation time, less blood loss and less medical cost ( P ＜ 0.05 ). Conlusion TVM could be performed in selected patients with several advantages, including more safety, less trauma, less pain, quicker recovery, lower complication rate and lower medical cost.
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