腹腔镜子宫动脉阻断联合子宫肌瘤切除术的临床研究  

Clinical Application of Laparoscopic Uterine Artery Occlusion Combined with Myomectomy for Uterine Myoma

作　　者：刘锦钰[1] 

机构地区：[1]淮北市妇幼保健院,安徽淮北235000

出　　处：《现代医院》2016年第2期191-193,197,共4页Modern Hospitals

基　　金：安徽省卫生计生委科研计划项目(编号:14FR015)

摘　　要：目的探讨腹腔镜下子宫动脉阻断术联合子宫肌瘤切除术的临床疗效。方法 68例子宫肌瘤患者随机分成对照组和观察组,观察组行腹腔镜下子宫动脉阻断联合切除子宫肌瘤术,对照组行常规腹腔镜子宫肌瘤切除术。比较两组手术时间、术中出血量、住院时间、术后病率及术后并发症。术后随访患者8个月,比较两组月经症状改善率、肌瘤复发率及术后卵巢储备功能。结果两组腹腔镜手术均成功完成。术中出血量观察组(58.3±22.6)m L低于对照组(75.1±26.6)ml,t=2.860 5,P=0.005 7;手术时间观察组(66.0±15.9)min明显少于对照组(80.2±21.6)min,t=3.087 1,P=0.002 9;肌瘤复发率观察组2.94%(1/34)低于对照组17.64%(6/34),2=3.981,P=0.046。两组患者住院时间、术后病率、术后并发症、月经症状改善率及术后卵巢储备功能比较,P>0.05,差异无统计学意义。结论腹腔镜子宫动脉阻断联合肌瘤切除术术中出血量少,手术时间短,术后肌瘤复发率低,随访时间内未见该手术对卵巢功能有明显影响,是一种安全有效的治疗子宫肌瘤的方法。Objective To explore the clinical curative effect of laparoscopic uterine artery occlusion combined with myomectomy. Methods 68 cases of hysteromyoma patients from January 2013 to October 2014 were randomly divided into study and control groups. The study group were treated with laparoscopic uterine artery occ Iusion before myomectomy while the control group underwent lapamscopic uterine myomectomy. The operation time,intraoperative blood loss,hospitalization time,postoperative morbidity and complications were compared. After postoperative follow- up for 8 months,recurrence rate of hysteromyoma,improvement rate of menstruation,and varian reserve function after operation were compared again. Results All surgeries in the two groups had been completed successfully. The blood loss in the study group was less than that of the control group[（ 58. 3 ± 22. 6） ml vs（ 75. 1 ± 26. 6） ml,t = 2. 8605,P = 0. 0057]. The operation time of the study group was significantly shorter than that of the control group [（ 66. 0 ± 15. 9） min vs（ 80. 2 ± 21. 6） min,t = 3. 0871,P = 0. 0029]; During the follow- up of 8 months,no significant difference was found in the recurrence rate of hysteromyoma,[2. 94%（ 1 /34）vs 17. 64%（ 6 /34）,P = 0. 046） ]. There is no significant difference between the two groups as for the operation time,postoperative morbidity and complications,improvement rate of menstruation as well as varian reserve function after operation.Conclusion Laparoscopic uterine artery occlusion combined with myomectomy for uterine myoma is of great benefit to reduce intraoperative blood loss as well as shorten operation time. It hasn＇t been found any bad effectiveness on ovary function. It is a safety and effective method for treatment of uterine fibroids.

关 键 词：子宫肌瘤 子宫肌瘤切除术 子宫动脉阻断 腹腔镜 

分 类 号：R737.33[医药卫生—肿瘤]