腹腔镜子宫肌瘤剔除术后子宫瘢痕影像消失的研究  

Study on Disappearance of Scar Images After Laparoscopic Myomectomy

作　　者：郝焰[1] 吴青青[2] 卢丹[1] 郑萍[1] 吴霞[1] 周琦[1] 盛洁[1] 魏薇[1] 段爱红[1] 李慧[1] 李斯静[2] Hao Yan;Wu Qingqing;Lu Dan(Department of Gynecology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100026,China)

机构地区：[1]首都医科大学附属北京妇产医院妇科,北京100026 [2]首都医科大学附属北京妇产医院超声医学科,北京100026

出　　处：《中国微创外科杂志》2018年第8期703-706,共4页Chinese Journal of Minimally Invasive Surgery

基　　金：首都医科大学附属北京妇产医院中青年学科骨干培养专项(FCYY201519)

摘　　要：目的探讨腹腔镜子宫肌瘤剔除术后子宫瘢痕愈合时间。方法选择2016年1～12月子宫肌瘤剔除术,单发子宫肌瘤,肌瘤直径5～9 cm,采用国际妇产科联盟(FIGO)子宫肌瘤9型分类方法,选择Ⅴ型(肌瘤贯穿全部子宫肌层)及突出浆膜层<50%的Ⅵ型(肌瘤突向浆膜)子宫肌瘤,最终完成随访Ⅴ型52例,Ⅵ型34例。术后2周、1个月、3个月,之后每3个月一次于月经干净10天内行阴道超声,将超声下瘢痕部位恢复正常子宫肌层回声界定为瘢痕消失。结果术后3个月前均未发现有子宫瘢痕消失,Ⅴ型术后6、9、12个月瘢痕消失率分别为15.4%(8/52)、59.6%(31/52)、92.3%(48/52),Ⅵ型分别为79.4%(27/34)、94.1%(32/34)、100%(34/34),术后6、9个月Ⅵ型均明显高于Ⅴ型(χ~2=34.920、12.491,P均=0.000),术后12个月2组无统计学意义(χ~2=1.283,P=0.257)。结论Ⅴ型子宫肌瘤剔除术后瘢痕影像多于9～12个月消失,突出浆膜层<50%的Ⅵ型子宫肌瘤剔除术后瘢痕多于6～9个月消失。阴道超声可用于监测腹腔镜子宫肌瘤剔除术后子宫瘢痕消失情况。Objective To explore the disappearing of scar images of the uterus after laparoscopic myomectomy. Methods Patients planned for laparoscopic myomectomy surgery from January 2016 to December 2016,with myomas 5-9 cm in diameter,were included in this study. According to the uterine fibroids 9 type classification method of International Federation of Gynecology and Obstetrics（ FIGO）,the type Ⅴ（ fibroids throughout all myometrium） and type Ⅵ（ fibroids protruding toward serosa） fibroids with highlight the serosa layer 〈50% were selected. Follow-ups were completed in 52 cases in the type Ⅴ group and 34 cases in the typeⅥ group. Vaginal ultrasound was performed at 2 weeks,1 month,and 3 months after operation,as well as every 3 months afterwards（ within 10 days after menstruation）. The scar ultrasonic echoes recovering to normal myometrium was defined as scar disappearance.Results No uterine scar disappeared within 3 months after surgery. The scar disappearing rates in the type Ⅴ group at 6,9 and 12 months after operation were 15. 4%（ 8/52）,59. 6%（ 31/52）,and 92. 3%（ 48/52）,respectively,and those in the type Ⅵ group were 79. 4%（ 27/34）,94. 1%（ 32/34）,and 100%（ 34/34）,respectively. At 6 and 9 months after the operation,the scar disappearing rates in the type Ⅵ group were significantly higher than those in the type Ⅴ group（ χ^2= 34. 920,12. 491; P = 0. 000,0. 000）. There was no statistical significance in the 2 groups at 12 months after surgery（ χ^2= 1. 283,P = 0. 257）. Conclusions The disappearing scar images usually happen in 9-12 months after operation for type Ⅴ fibroids,and 6-9 months after operation for type Ⅵ fibroids（ highlight the serosal layer 50%）. Vaginal ultrasonography can be used to monitor the disappearance of scar images after laparoscopic myomectomy.

关 键 词：腹腔镜子宫肌瘤剔除术 瘢痕 愈合 

分 类 号：R737.33[医药卫生—肿瘤]