腹腔镜下子宫动脉阻断术联合肌瘤切除术治疗子宫肌瘤的临床研究  

Clinical research of laparoscopic uterine artery occlusion combined with myomectomy for uterine fibroids

作　　者：程忠平[1] 杨伟红[1] 戴虹[1] 胡莉萍[1] 瞿晓燕[1] 康乐[1] 朱宇[1] 龚军[1] 关淇予[1] 

机构地区：[1]上海市杨浦区中心医院妇产科,200090

出　　处：《中国妇产科临床杂志》2009年第3期182-185,共4页Chinese Journal of Clinical Obstetrics and Gynecology

摘　　要：目的评价腹腔镜下子宫动脉阻断联合肌瘤切除术治疗子宫肌瘤的临床可行性及中远期疗效。方法对520例子宫肌瘤患者的临床资料进行回顾性分析,其中348例行腹腔镜下子宫动脉阻断联合肌瘤切除术(LUAO-M);172例行腹腔镜下单纯肌瘤切除术(LM),比较两种术式的相关手术指标及随访结果。结果LUAO组术中出血量(88.2±52.7)ml少于LM组(103.2±54.9)ml(P=0.003);LUAO组术后病率5.7%低于LM组19.2%(P<0.05);LUAO组术后住院天数(7.7±2.5)d低于LM组(8.6±3.2)d(P=0.001)。LUAO组术后子宫体积缩小率(48.9±38.6)%大于LM组体积缩小率(39.2±41.6)%(P=0.019);LUAO组月经过多缓解率97.0%高于LM组86.4%(P<0.05);LUAO组术后肌瘤复发率3.0%低于LM组10.7%(P=0.001)。结论腹腔镜下子宫动脉阻断术联合肌瘤切除术有助于拓宽腹腔镜下子宫肌瘤切除术的手术适应证,减少术中出血量,降低术后病率及子宫肌瘤复发率。Objective To evaluate the clinical feasibility and medium term and long - term therapeutic effect of laparoscopic uterine artery occlusion combined with myomectomy （LUAO- M） for uterine filoroids. Methods 348 patients with uterine fibroid performed by LUAO - M and 172 patients with uterine fibroid performed by laparoscopic myomectomy （LM） were retrospective analyzed. The operative and postoperative data, therapeutic effect, and follow- up were evaluated and compared. Results LUAO- M versus LM：blood loss, （88. 2±52.7） ml vs. （103.2±54. 9） ml （P=0. 003） ; febrile morbidity, 5.7%vs. 19.2% （P〈0. 05） ; the length of stay after operation, （7.7±2. 5） d vs. （8. 6＋3.2） d （P=0. 001） ; uterine volume reduction, （48. 9±38. 6）%vs （39.2±41.6）%（P=0. 019） ; the alleviation rate of menorrhagia, 97.1% vs. 86. 8% （P〈0.05） ; the recurrence rate of myoma, 3. 0%, vs. 10. 7% （P=0. 001）. Conclusion LUAO- M may expand conservative surgical indications of LM, decrease blood loss, reduce febrile morbidity and the recurrence rate of myoma.

关 键 词：腹腔镜 子宫肌瘤 子宫动脉阻断 子宫肌瘤切除术 

分 类 号：R737.33[医药卫生—肿瘤] R713.42[医药卫生—临床医学]