改良式腹腔镜下子宫动脉阻断术联合米非司酮对子宫肌瘤切除术患者的疗效研究  

Study on the application of modified laparoscopic uterine artery occlusion combined with mifepristone in patients undergoing hysteromyomectomy

作　　者：宋梅 赵囡囡 石银 糜娟 田桂锁 SONG Mei;ZHAO Nannan;SHI Yin;MI Juan;TIAN Guisuo(Department of Obstetrics and Gynecology,Yizheng Municipal People′s Hospital,Yangzhou 211400,Jiangsu,China)

机构地区：[1]仪征市人民医院妇产科,江苏扬州211400

出　　处：《中国性科学》2025年第2期47-51,共5页Chinese Journal of Human Sexuality

基　　金：2023年度江苏省妇幼保健科研项目(F202328)。

摘　　要：目的探讨改良式腹腔镜下子宫动脉阻断术联合米非司酮应用于行子宫肌瘤切除术患者的治疗效果。方法选取2020年4月至2023年4月仪征市人民医院收治的90例子宫肌瘤患者作为研究对象,按照奇偶号法分为未阻断组和阻断术组,每组45例。未阻断组采用腹腔镜下子宫肌瘤切除术联合米非司酮治疗,阻断术组在未阻断组基础上采用改良式腹腔镜下子宫动脉阻断术治疗。比较两组围手术期指标、临床疗效、手术前后卵巢功能、并发症发生率、复发率。结果阻断术组术中出血量低于未阻断组,排气和住院时间短于未阻断组(P<0.05);两组手术时间比较,差异无统计学意义(P>0.05)。术后6个月,阻断术组治疗总有效率高于未阻断组(P<0.05)。阻断术组月经恢复正常时间短于未阻断组(P<0.05);术后6个月,两组窦卵泡计数(AFC)、卵泡刺激素(FSH)、雌二醇(E_(2))、黄体生成素(LH)均升高,且阻断术组均高于未阻断组(P<0.05)。阻断术组并发症总发生率低于未阻断组(P<0.05)。术后12个月内,阻断术组总复发率低于未阻断组(P<0.05)。结论改良式腹腔镜下子宫动脉阻断术可降低行子宫肌瘤切除术患者术中出血量,促进卵巢功能恢复,减少并发症和复发情况。Objective To explore the application of modified laparoscopic uterine artery occlusion combined with mifepristone in patients undergoing hysteromyomectomy.Methods A total of 90 patients with hysteromyoma admitted to Yizheng Municipal People′s Hospital from April 2020 to April 2023 were selected as study objects.According to the odd-even number method,they were divided into non-occlusion group and occlusion group,with 45 cases in each group.The non-occlusion group were treated with laparoscopic hysteromyomectomy combined with mifepristone,and the occlusion group were treated with modified laparoscopic uterine artery occlusion on the basis of non-occlusion group.The perioperative indicators,clinical efficacy,ovarian function before and after surgery,incidence of complications and recurrence rate were compared between the two groups.Results The amount of intraoperative blood loss,exhaust time and hospital stay in occlusion group were significantly less or shorter than those in non-occlusion group(P<0.05),but no statistical difference was shown in operation time between the two groups(P>0.05).At 6 months after surgery,the total efficacy in occlusion group was higher than that in non-occlusion group(P<0.05).The menstrual recovery time was shorter in occlusion group than that in non-occlusion group(P<0.05).The antral follicle count(AFC),follicle-stimulating hormone(FSH),estradiol(E_(2)),luteinizing hormone(LH)in the two groups were all increased significantly at 6 months after surgery,and the levels in occlusion group were higher than those in non-occlusion group(P<0.05).The incidence of complications in occlusion group was lower than that in non-occlusion group(P<0.05).The recurrence rate within 12 months after surgery in occlusion group was lower compared to non-occlusion group(P<0.05).Conclusions Modified laparoscopic uterine artery occlusion can reduce the amount of intraoperative blood loss,promote the recovery of ovarian function,and ireduce complications and recurrence rate in patients undergoing hysteromyomec

关 键 词：改良式腹腔镜下子宫动脉阻断术 子宫肌瘤切除术 米非司酮 卵巢功能 子宫肌瘤复发率 

分 类 号：R711[医药卫生—妇产科学]