日间手术在子宫黏膜下肌瘤患者中的应用效果

郭春凤　黄修菊　刘念

[摘要] 目的 探讨日间手术模式宫腔镜下子宫肌瘤电切术的安全性及可行性。 方法 选择新疆医科大学第一附属医院2016年4～2017年10月按日间纳入标准收治的87例子宫黏膜下肌瘤患者（O型44例，Ⅰ型24例，Ⅱ型19例）作为研究组，选择同期符合日间手术标准住院治疗的112例子宫黏膜下肌瘤患者（O型55例，Ⅰ型32例，Ⅱ型25例）作为对照组。手术由同一医生及其团队完成，随访6个月。比较两组患者人均术前候床日数、术中情况、住院费、化验费、西药费、术后并发症发生情况、人均住院时间、再入院率、满意率等。 结果 两组手术时间、术中出血量、满意率比较，差异均无统计学意义（P > 0.05）；术后两组均无并发症发生，无非计划再入院发生；研究组术前候床日、人均住院时间较对照组显著缩短（P < 0.01），化验费、西药费、人均住院总费用较对照组显著降低（P < 0.05）。 结论 在严格把握各项准入标准的前提下，日间病房行宫腔镜下子宫肌瘤电切术安全高效、便捷，可明显降低住院时间及住院费用。

[关键词] 经宫颈子宫肌瘤电切术；日间手术；黏膜下子宫肌瘤；宫腔镜手术

[中图分类号] R737.33 [文献标识码] A [文章编号] 1673-7210（2018）09（b）-0077-04

[Abstract] Objective To investigate the safety and feasibility of hysteroscopic uterus myoma electromyoma in daytime operation ward. Methods From April 2016 to October 2017， 87 patients with uterus submucous myoma （44 cases of type O， 24 cases of type Ⅰ， 19 cases of type Ⅱ） admitted to the First Affiliated Hospital of Xinjiang Medical University according to day surgery standard were selected as the study group. In the same period， 112 patients with uterus submucous myoma （55 cases of type O， 32 cases of type Ⅰ， 25 cases of type Ⅱ） according to day surgery standard were selected as control group. The operation was completed by the same doctor and his team. Patients were followed up for 6 months. Preoperative per capita preoperation bed days， intraoperative conditions， hospitalization expenses， laboratory fees， cost of Western medicine， postoperative complications， per capita hospitalization time， readmission rate， satisfaction rate were compared between two groups. Results There were no significant differences in operation time， intraoperative bleeding and satisfaction rate between two groups （P > 0.05）. No complications and no plan of enterance to the hospital occurred in two groups after operation. Preoperative preoperation bed days， per capita hospitalization time in the study group were shorter than control group （P < 0.05）. The laboratory fees， cost of Western medicine per capita hospitalization expenses in study group were lower than control group （P < 0.05）. Conclusion Under the premise of strict admittance standards， hysteroscopic uterus myoma electromyoma in daytime operation ward is safe， efficient， convenient， and can reduce hospitalization time and hospitalization cost significantly.

[Key words] Transcervical hysteromyoma electric resection； Day surgery； Submucous uterine fibroids； Hysteroscopic surgery

子宫黏膜下肌瘤因肌瘤突向宫腔方向生长，引起月经量多、异常子宫出血、流产等。随着内镜技术的日臻完善，宫腔镜手术治疗子宫黏膜下肌瘤因其微创、保留生育功能等优点深受患者的青睐。以往均需住院手术，候床日长，住院时间长，术前占床日长。日间手术蓬勃发展，为广大患者提供了新的选择。新疆医科大学第一附属医院（以下简称“我院”）于2017年4月開展日间病房。为探讨该手术模式的安全性、可行性，现与同期住院病房子宫黏膜下肌瘤患者的临床数据进行对比，为临床提供参考。