腹腔镜次全子宫切除治疗子宫腺肌病的可行性研究  

Feasibility study of laparoscopic partial hysterectomy for adenomyosis of uterus.

作　　者：陈云卿[1] 郭小桥 朱小红[1] CHEN Yun-qing;GUO Xiao-qiao;ZHU Xiao-hong(Foshan First People＇s Hospital,Guangdong Foshan 528000,China)

机构地区：[1]佛山市第一人民医院,广东佛山528000

出　　处：《实用妇科内分泌电子杂志》2018年第25期27-29,共3页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的分析比较腹腔镜下子宫次全切除术及全切除术治疗子宫腺肌病的疗效差异。方法通过回顾性研究,收集我科2016年1月～2017年12月腹腔镜下治疗的225例子宫腺肌病患者。分组:LSH组(子宫次全切除术)70例;LTH组(子宫全切除术)155例。对两组患者进行指标评价:(1)手术时间、术中出血量;术后并发症发生率、盆腔脏器脱垂发生率、切缘异位病灶阳性率。(2)手术前后疼痛评分,术前及术后6月CA125值、性生活满意度评估。结果:(1)LSH组手术时间、术中出血量明显少于LTH组,而术后并发症发生率及盆腔脏器脱垂发生率明显低于LTH组,数据差异均有统计学意义(P<0.05)。LSH组及LTH组切缘阳性率分别为10%、9.7%,数据差异无统计学意义(P>0.05)。(2)两组患者术前疼痛评分、CA125及性生活满意度无明显统计学差异(P>0.05)。术后两组患者此三项指标均较术前明显下降,两组间无明显统计学差异(P>0.05)。结论:腹腔镜下次全子宫切除术是一种适合治疗子宫腺肌病的手术方式。Objective To analyze the efficacy of laparoscopic partial hysterectomy and total hysterectomy in the treatment of adenomyosis.Methods By retrospective study, We collected 225 cases of adenomyosis of uterus treated by laparoscopy in our department from January 2016 to December 2017. There were 70 cases in LSH group （partial hysterectomy） and 155 cases in LTH group （total hysterectomy）. Patients in the two groups were compared with the following indicators： ①Surgical duration and intraoperative blood loss; Incidence of postoperative complications, incidence of pelvic organ prolapse, positive rate of ectopic lesion. ②Pain score before and after surgery, CA125 value before surgery and 6 months after surgery, and sexual satisfaction evaluation.Results ①compared with the LTH group, the LSH group had less operative time, less intraoperative blood loss, lower incidence of postoperative complications and lower incidence of pelvic organ prolapse （P〈0.05）.The positive rates of cutting edge in LSH group and LTH group were 10% and 9.7% respectively, and the data difference was not statistically signi？cant （P〉0.05）. ②There was no signi？cant difference in pre - operative pain score, CA125 and sexual satisfaction between the two groups （P〉0.05）. Postoperative patients in both groups showed a signi？cant decrease in these three indicators compared with those before surgery（P〉0.05）.There was no significant difference in pre - operative pain score, CA125 and sexual satisfaction between the two groups （P〉0.05）. Postoperative patients in both groups showed a significant decrease in these three indicators compared with those before surgery, and there was no significant statistical difference between the two groups （P〉0.05）. Conclusion laparoscopic partial hysterectomy is a more suitable surgical method for adenomyosis of uterus.Conclusion： laparoscopic partial hysterectomy is a suitable surgical method for adenomyosis of uterus.

关 键 词：腹腔镜 子宫腺肌病 子宫次全切除术 子宫全切除术 

分 类 号：R713[医药卫生—妇产科学]