改良腹腔镜手术治疗子宫腺肌症的可行性及安全性研究  

Feasibility and Safety of Modified Laparoscopic Surgery in the Treatment of Adenomyosis

作　　者：王宇华[1] 杨宾烈[1] 张爱[1] 张云珠[1] 徐泠琳[2] 

机构地区：[1]上海市浦东新区人民医院妇产科,上海201200 [2]上海中医药大学附属曙光医院妇产科,上海201203

出　　处：《现代生物医学进展》2016年第13期2527-2529,共3页Progress in Modern Biomedicine

基　　金：浦东新区卫生系统领先人才培养计划(PWRI2010-04)

摘　　要：目的:探讨改良腹腔镜手术治疗子宫腺肌症的可行性及安全性。方法:84例子宫腺肌症患者,采用方便抽样方法选取接受改良腹腔镜子宫体楔形切除术的40例患者作为研究组,接受传统腹腔镜全子宫切除术的44例患者作为对照组,比较两组手术情况及术后康复情况。结果:两组术中出血量、手术时间、导尿管留置时间、引流管留置时间、肛门恢复排气时间比较差异无统计学意义(P>0.05);术后研究组性生活评分、生活质量评分高于对照组(P<0.05),痛经程度评与对照组比较差异无统计学意义(P>0.05);研究组压力性尿失禁、阴道顶端脱垂、直肠膨出发生率低于对照组(P<0.05)。结论:改良腹腔镜手术治疗子宫腺肌症的治疗效果与传统腹腔镜手术相当,但患者性生活及生活质量较高,且对盆底支撑功能影响较小。Objective： To investigate the feasibility and safety of improved laparoscopic surgery for adenomyosis of uterus. Methods： Among the 84 cases of uterine adenomyosis patients admitted in hospital, we selected by convenience sampling method 40 patients who accepted the modified laparoscopic uterine wedge resection as a study group, and 44 patients who accepted conventional laparoscopic hysterectomy surgery as the control group. We compared the surgery and postoperative rehabilitation situation between the two groups. Results There were no statistical difference in blood loss during operation, operative time, catheterization time, drainage tube indwelling time, anal exhaust recovery time between the two groups （P〉0.05）. After operation, the scores of sexual life and life quality of the study group were higher than those of the control group （P〈0.05）. The dysmenorrhea assessment score showed no significant difference be- tween the two groups （P〉0.05）. In study group, the incidences of stress urinary incontinence, top vaginal prolapsed and rectal prolapse were lower than in control group （P〈0.05）. Conclusion： The modified laparoscopic surgery had relatively equal curative effect for uterine adenornyosis with the conventional laparoscopic surgery, but a better sexual life and higher quality of life, and less impact on the pelvic floor support functions for patients.

关 键 词：子宫腺肌症 腹腔镜 子宫体楔形切除术 全子宫切除术 

分 类 号：R711.74[医药卫生—妇产科学]