Efficacy Of LH,TVH And TAH In The Treatment Of Uterine Fibroids

Objective To compare and analyze the clinical effects of laparoscopic hysterectomy,Transabdominal Hysterectomy and Transabdominal Total Hysterectomy in three patients with uterine fibroids,and the relationship between operation effect and uterine size.Methods A total of 663 hysteromyoma patients were selected in our hospital,According to the surgical methods,the laparoscopic group（group LH）,the vaginal group（group TVH）and the abdominal group（group TAH）,of which 237 cases in group LH were 45.32±2.86years old,the size of uterus was 13.38+2.85 weeks,221 cases in group TVH,45.17±3.07years old,and 13.85±2.86 weeks of pregnancy;TAH group 205 cases,age 45.32±5 years.The size of the uterus was 14.16±3.40 weeks.They were divided into three subgroups of uterus,12W,pregnant 12-16W,and pregnant 16W.Records and statistics of the three groups of patients（including age,size of the uterus,body mass index）;three surgical procedures for different sizes of the uterus operation time;postoperative recovery（anus exhaust time,bed activity time,discharge time）,blood red egg white（Hemoglobin,Hb）decline,infection,the incidence of complications and T lymphocyte group CD³⁺,CD^8+,CD⁴⁺,CD⁴⁺/CD⁸⁺changes.Results（1）There was no significant difference in the basic condition（age,uterine size,body mass index）between the three groups（P>0.05）.（2）The operation time:there was no significant difference between the three methods of operation>12W（P>0.05）.When the size of uterus was pregnant 12¹6W and the size of uterus>16W,the operation time of LH group and TVH group was significantly different from those in the TAH group,with statistical significance（P<0.05）.（3）Postoperative recovery:postoperative anus exhaust time,ambulation time and discharge time after operation in group TAH were later than group LH and TVH（P<0.05）.There was no significant difference between group LH and TVH group（P>0.05）.（4）Postoperative Hb changes:Hb in group TVH was significantly lower than before operation,and there was no significant decrease in Hb after operation in group LH and TAH group（P>0.05）;TVH group was significantly different from LH and TAH,statistically significant（P<0.05）.（5）The change of T lymphocyte in operation group:there was no significant change in CD³⁺,CD⁸⁺,CD⁴⁺and CD⁴⁺/CD⁸⁺in group LH and group TVH,and there was no significant difference between the two groups（P>0.05）.TAH group CD⁸⁺decreased significantly,CD³⁺,CD⁴⁺,CD⁴⁺/CD⁸⁺increased significantly,compared with LH group and TVH group,the difference was statistically significant（P<0.05）.（6）The incidence of infection and complications in the three groups was higher than that in the other two groups in group TVH（P<0.05）.Conclusions（1）In uterus"12W",LH operation has the advantages of short time,minimally invasive and clear vision.（2）Uterus>pregnancy 12W,especially giant uterine myoma or pelvic severe adhesions,TAH advantages are significant,operation is convenient,operation time is reduced,and patients are reduced.（3）TVH infection rate and TAH,compared with LH and TAH The incidence of complications is the highest and the bleeding is much more.（4）The clinical selection of hysteromyoma surgery should be individualized according to the specific conditions,and the minimally invasive surgery should not be blindly pursued.