探讨阴式子宫肌瘤剥除术及腹腔镜下子宫肌瘤剥除术两种微创术式剥除子宫肌瘤的临床效果。

选择2007年1月至2010年4月在本院确诊为子宫肌瘤，有手术适应证，要求保留子宫的95例患者为研究对象。按照患者自愿和配对选择方式，即入组条件相似的配对原则，将其分为阴式子宫肌瘤剥除组(n＝50)与腹腔镜子宫肌瘤剥除组(n＝45)，对两种术式进行对比分析(手术时间、术中出血量、术后肛门排气时间、术后疼痛率、术后病率及住院时间)。两组患者一般资料(年龄、孕次、产次、肌瘤个数和子宫肌瘤直径)比较，差异无显著意义(P>0.05) (本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象本人的知情同意，并与之签署临床研究知情同意书)。

两组手术持续时间、术中出血量、术后肛门排气时间、术后疼痛率、术后病率和住院时间等比较，差异有显著意义(P<0.05)。

在一定适应证下，阴式子宫肌瘤剥除术较腹腔镜下子宫肌瘤剥除术具有手术时间短，术后疼痛轻，肠功能恢复快，体表不留疤痕和住院时间短等优点。

To evaluate the clinical effects of two myomectomys by vaginal myomectomy and by laparoscopic surgery.

From January 2007 to April 2010, 95 cases with hysteromyoma were included into this study. They were divided into vaginal myomectomy group (n=50) and laparoscopic myomectomy group (n=45) according to the principle of similar condition. The study protocol was approved by the Ethical Review Board of Investigation in Human Beings of Suining First People's Hospital. Informed consent was obtained from all participants. There had no significant difference between two groups among ages, gravidities, parities, hysteromyoma pieces and diameter hysteromyoma, etc (P>0.05).

There had significant difference of duration of operation, blood loss, anal exhaust time, rates of postoperative pain, postoperative morbidity, hospital stay between two groups (P<0.05).

In certain indications, the vaginal myomectomys was done with shorter operative time, postoperative pain, faster recovery of intestinal function, the body surface without leaving scars, shorter hospital stay than the laparoscopy.