腹腔镜下改良子宫肌瘤切除术91例临床分析  

Clinical analysis of laparoscopic improved myomectomy with 91 cases

作　　者：程忠平[1] 胡丽萍[1] 陈晓残[1] 沈根娣[1] 帅桂珍[1] 季芳[1] 瞿晓燕[1] 康乐[1] 

机构地区：[1]上海市杨浦区中心医院妇产科,上海200090

出　　处：《中国微创外科杂志》2003年第3期235-237,共3页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的　探讨腹腔镜下改良子宫肌瘤切除术的手术技巧和疗效。　方法　通过对子宫切口设计、组织分离 剥离器使用、肌瘤营养血管处理等手术技巧和手术器械的改进 ,行腹腔镜下子宫肌瘤切除术 91例。根据术前B超检测 ,分成肌瘤径线≥ 70mm组和 <70mm组。　结果　术中共发现肌瘤 10 2个 ,其中肌壁间肌瘤 73个 (71 6 % )。手术时间为 (116 1± 4 5 7)min ,出血量 (81 7± 4 1 7)ml,术后住院时间 (8 0± 2 8)天 ,术后最高体温 (37 9± 0 5 )℃。肌瘤径线≥ 70mm组术中出血量 (95 2± 4 2 0 )ml ,<70mm组 (6 5 6± 31 7)ml(t=2 35 ,P <0 0 5 ) ;两组手术时间分别为 (119 1± 4 4 2 )min和 (112 9± 33 4 )min ,(t=0 6 9,P >0 0 5 )。　结论　腹腔镜改良子宫肌瘤切除术可缩短手术时间、减少术中出血 ,即使较大径线的子宫肌瘤也能达到较好的疗效。Objective To investigate the surgical techniques and clinical effect of laparoscopic improved myomectomy. Methods After the surgical techniques and instruments were improved, laparoscopic myomectomies were performed in 91 patients with uterine myoma. The maximum diameter of myoma was (60 4±11 9) mm (range, 25 mm～110 mm), and in 35 cases the myomas were ≥7 0 cm and in 56 cases <7 0 cm. Results A total of 102 uterine myomas were found in these 91 patients during operation, including 73 intramural myomas (71 6%). The duration of operation was (116 1±45 7) min., blood loss (81 7±41 7) ml, postoperative hospital stay (8 0±2 8) days and postoperative highest temperature of patients (37 9±0 5)℃. The blood loss of patients with uterine myoma ≥7 0 cm was (95 2±42 0) ml, and that of those with uterine myomas <7 0cm (65 6±31 7) ml ( t =2 35, P <0 05). The operation time was (119 1±44 2) min in group ≥7 0 cm and (112 9±33 4) min in group <7 0 cm ( t =0 69, P >0 05). Conclusions After the surgical techniques and instruments were improved, the operation time and the blood loss can be reduced, and better clinical effect obtained, even in patients with somewhat larger uterine myoma.

关 键 词：腹腔镜 子宫肌瘤 了宫肌瘤切除术 

分 类 号：R737.33[医药卫生—肿瘤]