腹腔镜下子宫动脉阻断术加子宫肌瘤剔除术对子宫肌瘤患者围手术期、术后并发症及生育的影响  

Effect of Laparoscopic Uterine Artery Occlusion Combined with Myomectomy on Perioperative and Postoperative Complications and Fertility of Patients with Uterine Fibroids

作　　者：陈光 陈钢[1] 王佩红[1] CHEN Guang;CHEN Gang;WANG Pei-hong(Department of Gynaecology,Hanzhong Central Hospital,Hanzhong,Shaanxi 723000,China)

机构地区：[1]汉中市中心医院妇科,陕西汉中723000

出　　处：《临床误诊误治》2020年第8期75-79,共5页Clinical Misdiagnosis & Mistherapy

基　　金：陕西省自然科学研究发展计划项目(2014JM63051)。

摘　　要：目的探讨腹腔镜下子宫动脉阻断术加子宫肌瘤剔除术对子宫肌瘤患者围手术期、手术后并发症及生育的影响。方法选取符合纳入及排除标准的子宫肌瘤96例,按手术方法不同分为阻断组(采用腹腔镜下子宫动脉阻断术加子宫肌瘤剔除术,54例)和常规组(采用腹腔镜下子宫肌瘤剔除术,42例)两组。比较两组围手术期情况(手术时间、术中出血量、术后排气时间、住院时间),术前及术后6个月内分泌激素水平[雌二醇(E2)、黄体生成素(LH)、促卵泡生成素(FSH)]和窦卵泡计数(AFC),术后6个月卵巢功能情况,术后并发症发生情况,以及随访2年妊娠和复发情况。结果阻断组术中出血量少于常规组,差异有统计学意义(P<0.01)。术前及术后6个月两组组内及组间血清E2、LH、FSH水平及AFC比较差异均无统计学意义(P>0.05)。两组术后6个月卵巢功能情况及各术后并发症发生情况比较差异亦均无统计学意义(P>0.05)。随访2年,两组妊娠率比较差异无统计学意义(P>0.05);阻断组复发率低于常规组,差异有统计学意义(P<0.05)。结论腹腔镜下子宫动脉阻断术加子宫肌瘤剔除术治疗子宫肌瘤患者可减少术中出血量,同时对内分泌激素水平、卵巢功能无明显负面影响,且术后并发症少、妊娠率高、复发率低。Objective To investigate the effect of laparoscopic uterine artery occlusion combined with myomectomy on perioperative and postoperative complications and fertility of patients with uterine fibroids.Methods A total of 96 patients with uterine fibroids who met with the inclusion and exclusion criteria were enrolled.According to the surgical method,they were divided into the occlusion group(undergoing laparoscopic uterine artery occlusion combined with myomectomy,n=54)and the conventional group(undergoing laparoscopic myomectomy,n=42).Comparisons between the 2 groups were made in terms of perioperative situation(duration of operation,intraoperative blood loss,postoperative exhaust time,length of hospital stay),endocrine hormone levels estradiol(E2),luteinizing hormone(LH),follicle stimulating hormone(FSH)and antral follicle count(AFC)before operation and at 6 months after operation,ovarian function at 6 months after operation,postoperative incidence of complications,pregnancy and recurrence of uterine fibroids during 2 years of follow-up.Results The intraoperative blood loss of the occlusion group was less than that of the conventional group(P<0.01).Comparisons of serum E 2,LH and FSH levels and AFC within the same group and between the 2 groups before operation and at 6 months after operation showed no statistically significant differences(P>0.05).There was no significant difference in ovarian function at 6 months after operation or occurrence of postoperative complications between the 2 groups(P>0.05).After 2 years of follow-up,the difference in pregnancy rate between the 2 groups was not statistically significant(P>0.05),but the recurrence rate in the occlusion group was lower than that in the conventional group(P<0.05).Conclusion Laparoscopic uterine artery occlusion combined with myomectomy for treating patients with uterine fibroids can reduce intraoperative blood loss,without significant negative influence on hormones or ovarian function.In addition,this leads to fewer postoperative complications,higher post

关 键 词：平滑肌瘤 子宫疾病 腹腔镜 子宫肌瘤剔除术 子宫动脉阻断术 卵巢功能 雌二醇 促卵泡生成素 黄体生成素 手术后并发症 生育力 

分 类 号：R711.74[医药卫生—妇产科学] R738.7[医药卫生—临床医学]