开腹与腹腔镜下子宫肌瘤切除术后患者妊娠结局的临床分析

摘要

目的:探讨开腹与腹腔镜下子宫肌瘤切除术对子宫肌瘤患者术后妊娠结局的影响.方法:选取2013年5月至2014年5月收治的120例子宫肌瘤患者,根据随机数字表法分为开腹组(行开腹子宫肌瘤切除术,n=62)与腹腔镜组(行腹腔镜下子宫肌瘤切除术,n=58),观察两组手术情况及术后妊娠结局.结果:开腹组切除肌瘤数量、最大肌瘤直径均大于腹腔镜组(P<0.05);腹腔镜组住院时间、术中出血量均少于开腹组(P<0.05);两组总妊娠率、早产率、流产率、分娩方式、妊娠期高血压及糖尿病、异位妊娠发生率、术后6个月复发率差异无统计学意义(P>0.05);两组肌壁间肌瘤、浆膜下肌瘤患者的妊娠率差异有统计学意义(P<0.05).结论:有生育要求的子宫肌瘤患者行腹腔镜或开腹子宫肌瘤切除术均是安全、可行的,且母婴结局均较好.%Objective:To investigate the influence of laparoscopic and open myomectomy on postoperative pregnancy outcome for patients with uterine fibroids .Methods:One hundred and twenty patients with uterine fibroids who received myomectomy from May 2013 to May 2014 were chosen and assigned into the open group (received open myomectomy,n=62) and the laparoscopic group (re-ceived laparoscopic myomectomy ,n=58 ) by random number table method .The operation condition and postoperative pregnancy out-come of the two groups were compared .Results:The number of myoma removed and the diameter of the largest myoma of the open group were more than those of the laparoscopic group (P<0.05).The hospital stay and intraoperative blood loss of the laparoscopic group were less than those of the open group (P<0.05).The differences of pregnancy rate,premature delivery rate,abortion rate,delivery mode,hypertension,diabetes,incidence of ectopic pregnancy and recurrence rate 6 months after surgery between the two groups were not statistically significant (P>0.05).The pregnancy rates of intramural myoma patients and subserous myoma patients after surgery be -tween the two groups were significantly different (P<0.05).Conclusions:For patients with uterine fibroids who have fertility require-ments,laparoscopic and open myomectomy are safe ,feasible and efficient for both mother and fetus .