子宫动脉临时阻断在腹腔镜子宫手术中的应用  

Application of Temporary Uterine Artery Blocking in Laparoscopic Uterine Operation

作　　者：赵新玲[1] 范造峰 白玉[1] 张悦[1] 张洋洋[1] 

机构地区：[1]河南省洛阳市妇女儿童医疗保健中心妇科,洛阳471000

出　　处：《中国微创外科杂志》2017年第6期501-503,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨子宫动脉临时阻断(temporary uterine artery blocking,TUAB)在腹腔镜子宫手术中的应用效果。方法回顾性分析2015年1月~2016年10月实施TUAB的65例资料,其中剖宫产瘢痕妊娠36例,输卵管间质部妊娠16例,子宫肌瘤13例(巨大子宫肌瘤5例,阔韧带肌瘤3例,子宫侧壁肌瘤3例,宫颈肌瘤2例)。先用10号丝线打活结阻断双侧子宫动脉,常规完成手术,抽去结扎线。结果 65例手术均顺利完成,行宫、腹腔镜联合剖宫产瘢痕妊娠物清除+子宫修补术36例,腹腔镜输卵管间质部妊娠物清除+子宫修补术16例,腹腔镜子宫肌瘤剔除术13例,术中出血量分别为(35.0±24.1)ml、(40.0±27.6)ml、(72.3±43.0)ml,手术时间(83.1±23.3)min、(86.8±19.9)min、(91.5±24.3)min,术后住院时间(5.2±1.0)d、(4.9±0.6)d、(5.2±1.0)d。术中无大出血发生。术后盆腔感染1例(1.5%),无其他并发症发生。结论在有大出血风险的腹腔镜子宫手术中行TUAB手术安全,值得推广。Objective To discuss the application effect of laparoscopic temporary uterine artery blocking （TUAB） in uterine operation. Methods A retrospective analyses was made on clinical data of 65 patients （ including 36 cases of cesarean scar pregnancy, 16 cases of intramural pregnancy, and 13 cases of hysteromyoma） with laparoscopic TUAB from January 2015 to October 2016. We Firstly blocked bilateral uterine artery by tying slipknot with 10# silk, then completed operation, and took out ligature at last. Results All the 65 operations were successfully completed, include laparoscopic combined hysteroscopic cesarean scar pregnancy resection and uterine repair in 36 cases, laparoscopic intramural pregnancy resection and uterine repair in 16 cases, and laparoscopic myomectomy in 13 cases. The mean intraoperative blood loss was （35.0 ± 24.1 ） ml, （40.0 ± 27.6） ml, and （72.3 ±43.0） ml, respectively. The mean operative time was （83. 1± 23. 3） rain, （86. 8 ± 19. 9） min, and （91. 5 ± 24. 3） min, respectively. The average postoperative hospital stay was （5.2± 1.0） d, （4.9 ± 0.6） d, and （5.2±1.0） d, respectively. There was no massive intraoperative hemorrhage or complications except for 1 case of pelvic infection postoperatively. Conclusion TUAB in laparoscopic uterine operation with risk of massive intraoperative hemorrhage is safe and worthy to application.

关 键 词：子宫动脉临时阻断 妇科手术 剖宫产瘢痕妊娠 输卵管间质部妊娠 子宫肌瘤 

分 类 号：R713.4[医药卫生—妇产科学]