腹腔镜子宫肌瘤切除术中先行子宫动脉阻断治疗子宫肌瘤的临床体会  

Clinical analysis of uterine artery block before laparoscopic myomectomy

作　　者：甄小文[1] 吴绮霞[1] 冯满欢[1] 杨晓青[1] 

机构地区：[1]开平市中心医院,广东开平529300

出　　处：《腹腔镜外科杂志》2011年第5期333-336,共4页Journal of Laparoscopic Surgery

摘　　要：目的:观察子宫动脉阻断在腹腔镜子宫肌瘤切除术中的应用效果。方法:随机将60例浆膜下或肌壁间肌瘤患者分为观察组(切除子宫肌瘤前先阻断子宫动脉)和对照组(不阻断子宫动脉)各30例。对比分析两组手术前后血生殖激素水平的变化、手术时间、术中出血量、术后排气时间、住院时间、术后病率,随访子宫肌瘤复发及月经改善情况。结果:所有患者腹腔镜手术均获成功,观察组术中出血明显少于对照组,手术时间和术后排气时间短于对照组,术后病率低于对照组(P<0.05);平均住院时间两组无明显差异(P>0.05);术后子宫肌瘤复发率(3.3%vs.16.7%)、月经过多改善率(100%vs.83.3%)差异有统计学意义(P<0.05);观察组术后2个月FSH水平上升,E2水平下降,与术前相比差异有统计学意义(P<0.05),对照组激素水平与术前的差异无统计学意义(P>0.05),术后12个月两组性激素水平与术前相比无明显差异(P>0.05)。结论:子宫动脉阻断明显减少了术中出血量,手术时间缩短,术后患者康复快,症状改善率高,复发率低,对卵巢功能的影响是短暂、可逆的。Objective：To discuss the effect of uterine artery block before laparoscopic myomectomy.Methods：Sixty patients with subserous or intramural myoma were randomly devided into research group（blocking uterine arteries before resecting hysteromyomas）,and control group（resecting hysteromyomas directly）,30 cases of each group.Levels of serum reproductive hormones were measured before and after operation.The operative time,blood loss,the passing flatus time,hospital stay,febrile morbidity,hysteromyoma recurrence and improvement of menstruation were compared between the two groups.Results：All patients accepted successful laparoscopic hysteromyomas.The blood loss,operative time,postoperative passing flatus and febrile morbidity in research group were less than those in control group（P0.05）.There was no significant difference in the mean hospital stay（P0.05）.The rate of hysteromyoma recurrence and hypermenorrhea improvement in research group were better than those in control group（P0.05）.Serum FSH increased and E2 decreased in research group 2 months after operation（P0.05）,but no change was observed in control group（P0.05）.12 months after operation,serum FSH,LH and E2 level were almost the same as those before operation in both groups（P0.05）.Conclusions：Blocking uterine arteries in laparoscopic myomectomy can obviously decrease blood loss,reduce operative time and achieve rapider recovery,higher rate of symptom improvement and lower recurrence rate.The influence on ovarian function is temporal and reversible.

关 键 词：子宫肌瘤 子宫肌瘤切除术 腹腔镜检查 子宫动脉阻断 

分 类 号：R737.33[医药卫生—肿瘤]