不同术式子宫肌瘤剔除治疗子宫肌瘤280例临床观察  

Clinical observation on 280 cases with hysteromyoma treated with different ways of myomectomy

作　　者：欧阳煜宏[1] 

机构地区：[1]辽宁省沈阳市第五人民医院妇产科,110023

出　　处：《中国妇幼保健》2011年第36期5831-5834,共4页Maternal and Child Health Care of China

摘　　要：目的:比较腹腔镜或开腹下肌瘤剔除或先行双侧子宫动脉阻断治疗子宫肌瘤的临床效果,探讨腹腔镜下肌瘤剔除术中先行双侧子宫动脉阻断术的优越性。方法:选择2003～2008年收治的要求保留子宫的子宫肌瘤患者280例,其中腹腔镜肌瘤剔除术(LM)组81例、腹式肌瘤剔除术(AM)组64例、腹腔镜下子宫动脉阻断联合肌瘤切除术(LUAO-M)组70例、腹式下子宫动脉阻断联合肌瘤切除术(AUAO-M)组65例。观察4组患者的围手术期情况,包括手术时间、术中出血量、术中及术后并发症、术后排气时间、感染率和住院天数,术后随访2年观察患者子宫恢复、月经症状缓解、肌瘤复发情况以及是否发生闭经,检测患者月经中期血雌激素水平。结果:LM组患者的术中出血量明显少于AM组,术后排气时间明显早于AM组,住院天数和感染率明显少于AM组;AUAO-M组患者的术中出血量明显少于AM和LM组;LUAO-M组患者的术中出血量明显少于AM、LM和AUAO-M组,术后排气时间明显早于AM和AUAO-M组,术后住院天数明显少于AM、LM和AUAO-M组,术后感染率明显低于AM组。术后随访2年,LM组肌瘤复发率明显高于AM组;AUAO-M组和LUAO-M组子宫恢复正常率和月经症状缓解率明显高于LM和AM组,而肌瘤复发率明显低于LM和AM组。结论:腹腔镜下子宫动脉阻断联合肌瘤切除术能明显减少术中出血和术后住院时间,有效促进子宫恢复、缓解月经异常、降低肌瘤复发,是治疗子宫肌瘤并保留子宫的一种安全、有效的手术方法。Objective：To compare the clinical effects of laparoscopic myomectomy（LM）,transabdominal myomectomy（AM）,laparoscopic myomectomy combined with bilateral uterine artery occlusion（LUAO-M） and transabdominal myomectomy combined with bilateral uterine artery occlusion（AUAO-M） in treatment of hysteromyoma,explore the advantages of LUAO-M.Methods：280 patients with hysteromyoma who had the demand to retain uteri and were treated in the hospital from 2003 to 2008 were selected,including 81 patients in LM group,64 patients in AM group,70 patients in LUAO-M group and 65 patients in AUAO-M group.The perioperative conditions in the four groups were observed,the contents included operation time,the amount of blood loss during operation,the postoperative exhaust time,the infection rate and hospitalization time,all the patients were followed up for two years after operation,the contents included uterine recovery,remission of menstrual symptoms,the recurrence of hysteromyoma and amenorrhea or not;the blood estrogen levels in the four groups were detected during the middle stage of menstruation.Results：The amount of blood loss during operation in LM group was significantly less than that in AM group;the postoperative exhaust time in LM group was significantly earlier than that in AM group;the hospitalization time and infection rate in LM group were significantly lower than those in AM group;the amount of blood loss during operation in AUAO-M group was significantly less than those in AM group and LM group;the amount of blood loss during operation in LUAO-M group was significantly less than those in AM group,LM group and AUAO-M group;the postoperative exhaust time in LUAO-M group was significantly earlier than those in AM group and AUAO-M group;the hospitalization time in LUAO-M group was significantly less than those in AM group,LM group and AUAO-M group;the infection rate in LUAO-M group was significantly lower than that in AM group.After follow-up for two years,the recurrence rate of hysteromyoma in LM group

关 键 词：子宫肌瘤 腹腔镜 子宫动脉阻断 子宫肌瘤剔除术 

分 类 号：R711.74[医药卫生—妇产科学]