腹腔镜下子宫动脉阻断后子宫肌瘤剔除术治疗子宫肌瘤临床分析  

Laparoscopic hysteromyomectomy after uterine artery blockage for hysteromyoma

作　　者：蒋琼[1] 张梅[1] 

机构地区：[1]十堰市中医医院妇科,湖北十堰442012

出　　处：《中华实用诊断与治疗杂志》2016年第10期987-989,共3页Journal of Chinese Practical Diagnosis and Therapy

基　　金：湖北省自然科学基金(2012CDB06802)

摘　　要：目的观察腹腔镜下子宫动脉阻断术对子宫肌瘤剔除术的疗效及预后的影响。方法 300例子宫肌瘤患者随机分为对照组和观察组各150例。对照组采用单纯腹腔镜下子宫肌瘤剔除术,观察组行子宫肌瘤剔除前先于腹腔镜下行子宫动脉阻断。比较2组术中情况、术后复发及并发症发生情况;比较2组术前及术后3、6个月血清卵泡刺激激素(follicle-stimulating hormone,FSH)、雌二醇(estradiol,E_2)、黄体生成素(luteinizing hormone,LH)水平。结果观察组术中出血量[(228.8±33.7)mL]、手术时间[(123.2±12.5)min]、术后月经量(0.64±0.12)及术后复发率(5.3%)、发热率(12.0%)、腹痛率(10.0%)均低于对照组[(277.4±19.5)mL、(141.0±15.4)min、1.02±0.18、19.3%、23.3%、20.7%](P<0.05);观察组术前及术后3、6个月血清E_2[(114.3±19.2)、(111.3±16.4)、(108.2±16.5)ng/L)]、FSH[(6.8±1.2)、(7.1±1.8)、(7.3±1.5)u/L)及LH[(7.6±2.0)、(7.2±1.7)、(7.0±2.1)u/L]水平与对照组[E2(112.7±17.1)、(110.5±16.9)、(107.6±17.8)ng/L,FSH[(6.6±1.3)、(6.8±1.5)、(7.1±1.2)u/L,LH[(7.3±2.1)、(7.1±1.8)、(6.8±1.9)u/L)]比较差异无统计学意义(P>0.05)。结论腹腔镜下子宫动脉阻断后子宫肌瘤剔除术可减少术中出血量,降低术后复发和并发症发生率,对患者生殖系统内分泌功能无明显影响。Objective To observe the curative effect of laparoscopic hysteromyomectomy after uterine artery blockage on hysteromyoma and the influence on the prognosis. Methods A total of 300 patients with hysteromyoma were randomly divided into observation group and control group, with 150 patients in each group. Observation group received uterine artery blockage before hysteromyomectomy and control group received laparoscopic hysteromyomectomy. The operation condition, hysteromyoma recurrence and postoperative complications were compared between two groups. The levels of follicle-stimulating hormone （FSH）, luteinizing hormone （LH） and estradiol （E2） were compared before, and 3 and 6 months after operation between groups. Results The intraoperative blood loss （（228. 8 ± 33. 7） mL）, postoperative menstruation volume （0.64±0. 12）, hystemmyoma recurrence rate （5.3%）, postoperative pyrexia （12.0%） and the incidence of postoperative abdominal pain （10.0 %） were significantly lower, and the operation lasting time （（123.2 ± 12.5） min） was significantly shorter in observation group than those in control group （（277.4±19.5） mL, 1.02±0.18, 19.3%, 23.3%, 20. 7%, （141.0± 15.4） min） （P〈0.05）. There were no significant differences in the levels of E2 （（114.3±19.2）, （111.3±16.4）, （108.2±16.5） ng/L）, FSH （（6.8±1.2）, （7.1±1.8）, （7.3±1.5） u/L） and LH （（7.6±2. 0）, （7. 2± 1. 7）, （7. 0 ± 2. 1） u/L） before, and 3 and 6 months after operation in observation group in comparison with those in control group （E2： （112.7±17.1）, （110.5±16. 9）, （107. 6±17.8） ng/L; FSH： （（6. 6± 1.3）, （6.8±1.5）, （7.1±1. 2） u/L; LH.. （7. 3±2. 1）, （7. 1±1. 8）, （6. 8±1. 9） u/L）） （P〉0.05）. Conclusion Laparoscopic hysteromyomectomy after uterine artery blockage can obviously reduce the intraoperative blood loss, reduce the recurrence rate of hystemmyoma and incidence of complications, with li

关 键 词：子宫肌瘤 子宫动脉阻断 腹腔镜 

分 类 号：R737.33[医药卫生—肿瘤]