探讨子宫肌瘤(UM)原位旋切法，在腹腔镜下子宫肌瘤剔除术(LM)的应用价值。

采用随机信封法，随机抽取2014年6月至2018年6月，于成都市妇女儿童中心医院妇科接受LM治疗的72例UM患者为研究对象。采用随机数字表法，将这72例患者随机分为研究组(n＝36，采取UM原位旋切法进行LM治疗)和对照组(n＝36，采取UM剥除后再旋切方法进行LM治疗)。采用成组t检验，对2组患者的手术时间、术中出血量、术后排气时间、住院时间进行统计学比较。本研究遵循的程序符合成都市妇女儿童中心医院伦理委员会制定的标准，经过该伦理委员会批准(批准日期：2014年4月14日)，并与所有受试者签署临床研究知情同意书。

①2组患者UM最大直径、年龄、人体质量指数(BMI)及腹部手术史、经产妇、UM数量≥2个所占比例等一般临床资料分别比较，差异均无统计学意义(P>0.05)。②研究组患者手术时间为(42.4±5.5) min，明显短于对照组的(78.6±6.0) min，术中出血量为(20.5±4.2) mL，明显少于对照组的(48.2±5.1) mL，2组分别比较，差异均有统计学意义(t＝3.762、3.523，P＝0.001、0.012)。2组患者术后肛门排气时间及住院时间分别比较，差异均无统计学意义(P>0.05)。2组患者均未发生手术相关并发症。

在LM中，采用UM原位旋切法治疗UM患者，可以缩短手术时间、减少术中出血量。因本研究纳入样本量相对较小，该方法是否值得临床推广、应用，尚待多中心、大样本、随机对照试验进一步研究、证实。

To explore the value of uterus myoma (UM) treatment by in situ morcellation of UM in laparoscopic myomectomy (LM).

A total of 72 patients who were diagnosed as UM and received LM treatment in Chengdu Women′s and Children′s Central Hospital between June 2014 and June 2018 were randomly selected as research subjects by random envelope method. By random number table method, the patients were randomly divided into study group (n=36, treatment UM by in situ morcellation of UM in LM) and control group (n=36, stripping UM first and then morcellation of UM in LM). The operation duration time, volume of intraoperative blood loss, postoperative vent time, and length of hospital stays were compared between two groups by independent-samples t test. The procedures followed in this study were in accordance with the standards established by the Ethics Committee of the Chengdu Women′s and Children′s Central Hospital, and this study was approved by this committee (approval date: April 14 of 2014). Clinical research informed consent was obtained and signed from each patient.

①There were no statistically significant differences between two groups in the general clinical data, such as maximum diameter of UM, and the age, body mass index (BMI), and proportions of history of abdominal surgery, multipara, number of UM ≥2 of patients (P>0.05). ②The operation duration time in study group was (42.4±5.5) min, which was statistically shorter than that of (78.6±6.0) min in control group, and volume of intraoperative blood loss in study group was (20.5±4.2) mL, which was significantly lower than that of (48.2±5.1) mL in control group, and both the differences were statistically significant (t=3.762, 3.523; P=0.001, 0.012). There were no significant differences between two groups in the postoperative vent time and length of hospital stays (P>0.05). There were no surgically related complications in both groups.

Applying in situ morcellation of UM in LM in treatment of UM patients is an efficient way to further reduce operative duration time and the volume of intraoperative blood loss. Because the sample size of this study is relatively small, whether this method is worthy of clinical promotion and application still needs to beconfirmed by multi-center, large-sample size, and randomized controlled trials.