腹腔镜子宫动脉阻断联合腺肌瘤切除治疗子宫腺肌病的临床观察  

A clinical observation of treating adenomyosis with laparoscopic uterine artery blockage combined with adenomyoma excision

作　　者：余琳[1] 全晓广[1] YU Lin;QUAN Xiaoguang(Department of Gynecology,Nanhai District Maternal and Child Health Hospital of Foshan City,Guangdong,Foshan 528200,China)

机构地区：[1]广东省佛山市南海区妇幼保健院妇科,广东佛山528200

出　　处：《中国医药科学》2020年第20期122-125,共4页China Medicine And Pharmacy

摘　　要：目的观察分析腹腔镜下腺肌瘤切除术中应用双侧子宫动脉阻断的临床效果。方法2017年1月~2018年5月对32例子宫腺肌瘤患者于腹腔镜下行双侧子宫动脉阻断,再行子宫腺肌瘤切除术。观察术中情况包括出血量、手术持续时间、切除标本重量、邻近脏器损伤发生率,以及术后肛门排气时间、住院时间。分析比较术前和术后1、6、12、18、24个月的VAS痛经评分、月经失血量、血红蛋白计数、子宫体积、CA125水平。比较术前及术后1、6、12、18、24个月FSH、LH及E2水平变化。结果平均术中出血量为(86.92±17.58)mL,平均手术时间为(61.93±4.62)min,平均切除标本重量为(175.56±37.42)g,无并发症发生。平均术后肛门排气时间为(16.22±2.63)h,平均住院时间为(4.78±0.64)d。术后子宫体积明显缩小,有效减少月经量,血红蛋白计数显著提高,术后痛经评分、CA125水平明显降低。术前及术后1、6、12、18、24个月FSH、LH、E2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联合子宫肌腺瘤病灶切除术有效、安全、创伤小,对卵巢功能无明显影响。Objective To observe and analyze the clinical effect of applying bilateral uterine artery blockage in laparoscopic adenomyoma excision.Methods From January 2017 to May 2018,32 patients with adenomyoma underwent laparoscopic bilateral uterine artery blockage,and then adenomyoma excision.The intraoperative conditions were observed,including blood loss,operation duration,weight of the excised specimen,incidence of injury to adjacent organs,and postoperative anal exhaust time and hospitalization days were also observed.The dysmenorrhea VAS scores,menstrual blood loss,hemoglobin count,uterine volume and CA125 level before and 1m,6m,12m,18m and 24m after operation were analyzed and compared.The changes of the levels of FSH,LH and E2 before and 1m,6m,12m,18m and 24 m after operation were compared.Results The mean intraoperative blood loss was(86.92±17.58)mL,the mean operation duration was(61.93±4.62)min,the mean weight of the excised specimen was(175.56±37.42)g,and no complications occurred.The mean postoperative anal exhaust time was(16.22±2.63)h,and the mean hospitalization time was(4.78±0.64)d.After operation,the uterine volume was significantly reduced,the menstrual amount was effectively reduced,the hemoglobin count significantly increased,and the dysmenorrhea VAS scores and CA125 level significantly decreased.The differences of FSH,LH and E2 before and 1m,6m,12m,18m and 24m after operation were statistically insignificant(P>0.05).Conclusion Laparoscopic uterine artery blockage combined with local excision of adenomyoma is effective,safe and minimally invasive,and has no obvious effect on ovarian function.

关 键 词：子宫腺肌病 腹腔镜 子宫动脉阻断 腺肌瘤切除 

分 类 号：R711.74[医药卫生—妇产科学]