Application Effect of Laparoscopic Myomectomy and Comprehensive Rehabilitation Nursing on Patients with Uterine Fibroids

Abstract

Background. Uterine fibroids are most common in women aged 30-50 and are the most common benign gynecological tumors. Relevant data suggest that about 25% of patients with uterine fibroids are at childbearing age. Uterine fibroids not only cause the discomfort symptoms, and affect the pregnancy, but also have certain malignant transformation risk, thus needed to be treated positively and promptly. Aim. This study is aimed at exploring the effect of laparoscopic myomectomy and comprehensive rehabilitation nursing on patients with uterine fibroids. Methods. The clinical data of 110 cases of uterine fibroids admitted to our hospital from August 2019 to December 2021 were analyzed retrospectively, and they were divided into two groups according to postoperative rehabilitation strategies. Both groups were treated with laparoscopic myomectomy. The A group was treated with routine rehabilitation strategy, while the B group was treated with comprehensive rehabilitation nursing strategy. The differences in operation-related indicators, stress factors, inflammatory factors, nutritional indicators, knowledge mastery, occurrence of adverse symptoms and pain scores, negative emotion scores, nursing satisfaction, and simplified comfort status scale (GCQ) scores between the two groups under nursing strategies were compared. Results. The postoperative exhaust time ( 13.14 ± 2.03 ) h, bed time ( 9.86 ± 1.94 ) h, postoperative hospital stay ( 4.37 ± 1.31 ) d, and total hospital stay ( 6.78 ± 1.69 ) d in the B group were shorter than those in the A group, and the hospitalization expenses ( 0.74 ± 0.25 ) million were less than those in the A group ( P < 0.05 ). Before operation, stress factors, inflammatory factors, and nutritional indexes were compared between the two groups ( P > 0.05 ). On the 3rd day after operation, tumor necrosis factor-α (TNF-α), cortisol (Cor), norepinephrine (NE), and interleukin-1β (IL-1β) in the two groups showed a significantly upward trend compared with those before operation, and albumin and transferrin were significantly fell compared with those before operation. However, the values of stress factor and inflammatory factor in the B group were significantly lower than those in the A group, and the values after the decrease of nutritional index were significantly higher than those in the A group ( P < 0.05 ). The pain scores at 24 h, 48 h, and 72 h after operation in the B group were significantly lower than those in the A group ( P < 0.05 ). Negative emotions, nursing satisfaction, and GCQ scores were compared between the two groups before intervention ( P > 0.05 ). After the intervention, the scores of Hamilton Depression Scale (HAMD) and Hamilton Anxiety Scale (HAMA) in the two groups were significantly lower than those before the intervention, and the scores of nursing satisfaction and GCQ were higher than those before the intervention. The values of negative emotions in the B group after the decline were significantly lower than those in the A group, while the values of nursing satisfaction and GCQ after the increase were higher than those in the A group ( P < 0.05 ). The excellent and good rate of knowledge acquisition in the B group was 94.55% (52/55), which was significantly higher than 78.18% (43/55) in the A group ( P < 0.05 ). The incidence of adverse symptoms in the B group was 9.09% (5/55), which was lower than 21.82% (12/55) in the A group, while the difference was not statistically significant ( P > 0.05 ). Conclusion. Laparoscopic myomectomy combined with comprehensive rehabilitation nursing can reduce the postoperative stress state of patients with uterine fibroids, improve patient satisfaction, reduce adverse emotions, and promote rehabilitation.

Curative Effect and Complication Rate of Abdominal Myomectomy and Laparoscopic Myomectomy in the Treatment of Uterine Fibroids

“…On the other hand, laparoscopic myomectomy is a minimally invasive technique. Its main advantages are as follows: (i) since a laparoscope is inserted through a small incision during surgery to observe the fibroids, the number, anatomical location, and size of the fibroids can be determined and physicians can remove the uterine fibroids under direct vision, thus ensuring the completeness of procedure [6] ; (ii) electrocoagulation is used in laparoscopic myomectomy to stop bleeding, and the precision of the procedure contributes to preventing injury to the surrounding tissues and organs of the myoma and reducing the amount of blood loss during surgery; (iii) the operation environment is relatively closed, and the operation accuracy is high, which can reduce the interference to the internal environment of the body; in addition, the incision is small, which can shorten the postoperative recovery time and reduce the risk of postoperative complications [7] .…”

“…In the present study, the postoperative ovarian function indicators of the study group were lower than those of the control group, suggesting that laparoscopic myomectomy can reduce the impact on ovarian function. Analyzing the reasons, since the incision is small and the procedure follows a minimally invasive approach, the stability of the adrenaline system can be maintained, the release of LH and FSH can be inhibited, the level of hormones in the body can be controlled, and the impact of surgery on ovarian function can be reduced [9] . This study showed that there were no significant differences in postoperative recurrence and pregnancy rates between the two groups, suggesting a similar efficacy between abdominal myomectomy and laparoscopic myomectomy in the long run.…”

Effect of comprehensive nursing intervention on wound pain and wound complications in patients with tonsillectomy: A meta‐analysis

“…[5][6][7] Comprehensive nursing is an emerging intervention nursing model that integrates the advantages of accountable care and group care, combines psychological care, dietary intervention, health education and other nursing methods and provides continuous and comprehensive nursing interventions by nursing staff to patients, which can support the recovery of tonsillectomy patients under general anaesthesia. [8][9][10] Zhou et al showed that comprehensive nursing intervention can significantly reduce the degree of postoperative wound pain and shorten the duration of postoperative pain in tonsillectomy patients. 11 Huang et al also showed that comprehensive nursing interventions for tonsillectomy patients in the postoperative period can rapidly control wound pain, shorten the duration of treatment and improve nursing satisfaction.…”