腹腔镜下子宫体楔形切除术的临床研究  

The investigation of the clinical effects of laparoscopic cuniform subtotal hysterectomy

作　　者：郭权[1] 刘贵鹏[1] 

机构地区：[1]中国医科大学附属盛京医院,辽宁沈阳110004

出　　处：《中国内镜杂志》2012年第1期34-37,共4页China Journal of Endoscopy

摘　　要：目的分析和探讨腹腔镜下实行子宫体楔形切除术的临床疗效。方法回顾性分析49例子宫腺肌症患者采取腹腔镜手术治疗的临床资料,13例子宫腹腔镜下子宫体楔形切除术,27例腹腔镜下病灶剔除术,9例腹腔镜下次全子宫切除术,采用统计学方法分析3组病例术中失血量、手术时间、术后肠功能恢复时间、腹腔引流量、术前术后的血清CA125、E2水平,以及经期腹痛情况。结果子宫体楔形切除组的血CA125、痛经缓解状况与次全子宫切除组相近,而术后的血E2则高于次全子宫切除组,差异有显著性,子宫体楔形切除组的血CA125、痛经缓解状况明显优于病灶剔除组,而术后的血E2则与病灶剔除组相近,3组在术中出血量、排气时间差异无显著性,P>0.05。结论在熟练手术技巧的前提下,在腹腔镜下实行子宫体楔形切除术保留了子宫动静脉上升支,保证了卵巢的血运,对无生育要求的子宫腺肌症患者来说无疑是一个理想的术式选择。[Obsjective] To investigate the clinical effects of laparoscopic cuniform subtotal hysterectomy to adenomyosis.[Methods] 49 cases of adenomyosis in our hospital,13 cases of laparoscopic cuniform subtotal hysterectomy（LC）,27 cases of laparoscopic focus removing（LF）,9 cases of laparoscopic subtotal hysterectomy respectively（LS） were reviewed retrospectively in terms of the operation duration,blood loss,intestine recovery,and before operation and 3 months after operation,the seral CA125,E2,and degree of dysmenorrheal.The paired t test was used for statistic analysis of the indexes of ante-and post-operation,P 0.05.[Results] The seral CA125 and the dysmenorrheal degree differ not significantly between LC and LS,but seral E2 higher in LC;The seral E2 differs not significantly between LC and LF,but the seral CA125 and the dysmenorrheal degree were better in LC without significant changes of the operation duration,blood loss and intestine recovery.[Conclusion] Laparoscopic cuniform subtotal hysterectomy is no injury to uterine artery and ovarian ligament,preserves the blood supplying and function of ovary.So for the cases of adenomyosis without needs of childbearing,laparoscopic cuniform subtotal hysterectomy is a good selection.

关 键 词：腹腔镜 子宫体楔形切除术 子宫腺肌症 

分 类 号：R711.71[医药卫生—妇产科学]