目的：探讨腹腔镜下多发性子宫肌瘤剥除术的临床治疗效及临床价值。方法选择2012年1月至2014年1月在江阴市人民医院妇科就诊的多发性子宫肌瘤280例,其中180例患者行腹腔镜下子宫肌瘤剥术除为观察组,100例患者行传统经腹子宫肌瘤剥除术为对照组,比较两组的手术时间、术中出血量、术后肛门排气时间、住院时间、残瘤率以及术后并发症发生情况。结果腹腔镜下多发性子宫肌瘤剥除术平均手术时间长于对照组；术后肛门排气时间、住院时间均短于对照组；术中出血量少于对照组,经比较差异均有统计学意义(Z值分别为-13.603、-13.856、-14.519、-11.376,均P<0.05)。腹腔镜下多发性子宫肌瘤剥除残瘤率稍高(5.56%),两组比较差异无统计学意义(χ2=0.948,P=0.330)。两组术后切口愈合不良、盆腔感染、子宫切口血肿、皮下气肿和静脉血栓并发症发生率比较差异均无统计学意义(χ2值分别为1.308、1.265、0.203、1.685,均P>0.05)。结论腹腔镜下多发性子宫肌瘤剥除可行、实用、临床效果好,是要求保留子宫患者有效、安全的治疗方式之一。%Objective To investigate the clinical efficacy and value of laparoscopic multiple myomectomy. Methods From January 2012 to January 2014 280 cases with multiple myomata admitted in Jiangyin Peoples ’ Hospital were divided into observation group undergoing laparoscopic multiple myomectomy ( 180 cases ) and control group undergoing trans-abdominal multiple myomectomy ( 100 cases ) . Operating time, intraoperative bleeding volume, postoperative anal exhaust time, hospitalization length, residual tumor rate and postoperative complications were compared between two groups. Results In observation group surgery duration was longer than that in the control group, postoperative anal exhaust time and hospitalization duration were shorter, and intraoperative bleeding volumewas less. The differences were significant (Z value was -13. 603, -13. 856, -14. 519 and -11. 376, respectively, all P<0. 05). Residual tumor rate after laparoscopic multiple myomectomy was slightly higher (5. 56%), but the difference was not significant (χ2 =0. 948,P =0. 330). There were no significant differences in the incidence of postoperative bad healing of incision, pelvic infection, hematoma of uterine incision, subcutaneous emphysema and phlebothrombosis (χ2 value was 1. 308, 1. 265, 0. 203 and 1. 685, respectively, all P>0. 05). Conclusion Laparoscopic multiple myomectomy is feasible and practical with good clinical effect, and it is one of effective and safe treatment for patients needing to retain uterus.
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