腹腔镜子宫动脉阻断联合子宫肌瘤剔除治疗子宫肌瘤的临床分析  

Clinical analysis of treatment for uterine myoma by uterine artery occlusion combined with 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]广东省开平市中心医院妇产科,广东开平529300

出　　处：《中国内镜杂志》2011年第11期1142-1146,共5页China Journal of Endoscopy

摘　　要：目的观察子宫动脉阻断在腹腔镜下子宫肌瘤剔除术中的临床效果。方法将60例浆膜下或肌壁间肌瘤患者随机分为观察组(行腹腔镜子宫肌瘤剔除前先行子宫动脉阻断)和对照组(直接行腹腔镜子宫肌瘤剔除术)各30例。比较两组手术前后血生殖激素水平的变化、两组手术时间、术中出血量、术后排气时间、住院时间、术后病率、术后子宫肌瘤复发及月经改善情况。结果所有病例腹腔镜手术成功,观察组术中出血量明显少于对照组,手术时间和术后排气时间观察组短于对照组,术后病率观察组低于对照组(均P<0.05);平均住院日两组比较差异无显著性(P>0.05);术后子宫肌瘤复发率观察组低于对照组,观察组术后月经过多改善率高于对照组,差异均有显著性(P<0.05);观察组术后2个月卵泡刺激素(FSH)水平上升,雌二醇(E2)水平下降,与术前自身对比差异有显著性(P<0.05),而对照组差异无显著性(P>0.05),术后12个月各组性激素水平与自身术前比较差异无显著性(P>0.05)。结论子宫动脉阻断具有明显减少腹腔镜下子宫肌瘤剔除时的出血量、缩短手术时间、术后恢复快、症状改善率高及复发率低等优点,对卵巢功能的影响是短暂、可逆的。[Objective] To perform a clinical analysis of uterine artery occlusion before laparoscopic myomectomy.[Methods] Sixty cases with subserous or intramural myoma were randomly divided into research group（blocking uterine arteries before rejecting hysteromyomas by laparoscope）（30 cases） and control group（directly rejecting hysteromyomas by laparoscope）（30 cases）.Serum reproductive hormone level was measured in the two groups pre-operation and post-operation.The duration of operation,the volumes of blood loss in operation,the time of passing flatus,length of stay and febrile morbidity in post-operation were compared between two groups during the follow-up months,hysteromyoma recidivism and improvement of menstruation were observed.[Results] All patients were rejected hysteromyomas by laparoscope.The volumes of blood loss,the duration of operation,postoperative passing flatus and febrile morbidity in post-operation in research group were less than those in control group（P 0.05）.There was no significant difference in the mean length of stay（P 0.05）.About hysteromyoma recidivism and the rate of hypermenorrhea improvement,there were significant differences between the two groups（P 0.05）,and hysteromyoma recidivism in research group was lower than that in control group,the rate of hypermenorrhea improvement in the research group was higher than that in control group.Compared with pre-operation,serum FSH（follicle-stimulating hormone） level increased while E2（estradiol） level decreased in research group 2 months after operation（P 0.05）,but not in control group（P 0.05）,12 months after operation,the serum FSH,LH（luteinizing hormone） and E2 level were almost the same as pre-operation in both groups（P 0.05）.[Conclusion] Blocking uterine arteries may possess several advantages such as obviously decreasing the volumes of blood loss in operation of hysteromyomas rejecting by laparoscope,reducing operative time,quicker convalescence,higher rate of symptom improvement and lower recu

关 键 词：腹腔镜 子宫肌瘤剔除术 子宫动脉阻断 

分 类 号：R713.4[医药卫生—妇产科学]