创新改良式手术治疗子宫腺肌病的应用价值  

Application value of innovative modified surgery for adenomyosis

作　　者：张彦骅[1] 李浏钰 李怡林[1] 刘青[1] Zhang Yanhua;Li Liuyu;Li Yiling;Liu Qing(Department of Gynecology,Gansu Provincial Maternal and Child Health Care Hospital,Lanzhou 730034,China)

机构地区：[1]甘肃省妇幼保健院妇一科,甘肃兰州730034

出　　处：《兰州大学学报（医学版）》2024年第10期57-61,共5页Journal of Lanzhou University（Medical Sciences）

基　　金：兰州市科技计划资助项目(2022-3-14,2023-4-69)。

摘　　要：目的比较创新改良式手术与传统手术治疗子宫腺肌病的临床疗效与应用价值。方法回顾性研究2020年6月—2022年2月在甘肃省妇幼保健院行保守性手术治疗子宫腺肌病符合纳入、排除标准的80例患者,分为创新改良式手术组(观察组)和传统手术组(对照组)。收集患者的临床资料,并术后随访,分析两种保守性手术治疗子宫腺肌病的疗效。结果两组患者治疗后痛经都较前缓解,观察组患者下降更显著。观察组患者经量术后明显减少,对照组患者经量术后短期内减少,术后半年经量同术前差异无统计学意义。观察组患者病灶复发程度明显低于对照组(P=0.049)。观察组患者手术后生活质量提高(P=0.041)。两组患者手术时间、术中出血量、术后并发症差异无统计学意义。两组患者手术均对卵巢储备功能无明显影响。结论两种手术方式均为治疗子宫腺肌病的有效方法。创新改良式手术在缓解患者症状、减少月经量、减少复发、提高患者生活质量等方面有明显优势,为病灶巨大、月经量多、症状严重的子宫腺肌病患者提供了一种保留子宫的新选择。Objective To compare the clinical efficacy and application value of an innovative modified conservative surgery with traditional conservative surgery in the treatment of adenomyosis.Methods A retrospective study was conducted on 80 patients who underwent conservative surgical treatment for adenomyosis in Gansu Provincial Maternal and Child Health Hospital from June 2020 to February 2022 and who met the inclusion criteria.The patients were divided into an innovative modified surgery group(the observation group)and a traditional surgery group(the control group).Their clinical data were collected,and follow-up conducted after surgery to analyze the efficacy of the two different conservative surgical treatments for adenomyosis.Results Dysmenorrhea was relieved in both groups,with a more significant decrease in the observation group.Menstrual flow in the observation group was significantly reduced postoperatively,while in the control group it decreased in the short term after surgery,followed by no significant difference six months after as compared with that before surgery.The degree of recurrence of lesions was significantly lower in the observation group than in the control group(P=0.049).And the quality of life was better than before surgery in the observation group(P=0.041).There were no significant differences between the two groups in terms of operative time,operative bleeding and postoperative complications and neither group saw any significant effect on ovarian reserve.Conclusions Both surgical methods are effective treatments for adenomyosis.The innovative modified conservative surgery has obvious advantages in alleviating patient symptoms,reducing menstrual flow,decreasing recurrence rates,improving the quality of life for patients.It offers a new uterussparing option for patients with adenomyosis who have large lesions,heavy menstrual bleeding,and severe symptoms.

关 键 词：子宫腺肌病 创新改良 保守性手术 临床疗效 应用价值 

分 类 号：R711.71[医药卫生—妇产科学]