腹腔镜下子宫切除联合子宫动脉阻断治疗子宫肌瘤的应用价值

目的:探讨腹腔镜下子宫肌瘤切除联合子宫动脉阻断术治疗子宫肌瘤的安全性和有效性.方法:将行腹腔镜下子宫肌瘤切除术的子宫肌瘤患者80例分为联合子宫动脉阻断术组(阻断组)和不联合子宫动脉阻断术组(对照组),比较2组患者的术中情况及术后恢复情况.结果:所有患者均痊愈出院,无中转开腹手术患者.阻断组患者手术时间、术中失血量、首次肠胃排气时间、术后住院时间和术后疼痛评分均明显少于或优于对照组(P<0.01).2组患者术前白细胞介素(IL-1)、IL-6和肿瘤坏死因子-α(TNF-α)水平差异均无统计学意义(P>0.05).阻断组术后3 d血清IL-1、IL-6 和 TNF-α水平均显著低于对照组(P<0.01).2组患者随访过程中,阻断组患者术后月经过多缓解率高于对照组(P<0.05),而月经量和肌瘤复发率均低于对照组(P<0.01和P<0.05).结论:接受腹腔镜下子宫动脉阻断的患者,手术耐受性好,出血少,术后炎性指标明显较低,随访远期疗效复发率较低,具有临床推广应用价值.

The application value of laparoscopic hysterectomy combined with uterine artery occlusion in the treatment of uterine fibroid

Objective:To evaluate the safety and effectiveness of laparoscopic myomectomy combined with uterine artery occlusion in the treatment of uterine fibroids. Methods:Eighty uterine fibroids patients treated with laparoscopic myomectomy were divided into the joint uterine artery occlusion group( blocking group) and non-jiont uterine artery occlusion( control group) . The intraoperative condition and postoperative recovery between two groups were compared. Results:All patients were cured and no conversion to open surgery. The operative time,intraoperative blood loss, stomach exhaust time, postoperative hospital stay and postoperative pain scores in blocking group were significantly less or better than those in control group(P<0. 01). The differences of the IL-1,IL-6 and TNF-αlevels before operation between two groups were not statistically significant(P>0. 05),the IL-1,IL-6 and TNF-α levels after 3 days of operation in blocking group were significantly less than those in control group(P<0. 01). During the period of following-up,the menorrhagia relieve rate in blocking group was higher than that in control group(P <0. 05),but the menstrual volume and fibroid recurrence rate in blocking group were significantly lower than those in control group(P <0. 01 and P <0. 05). Conclusions:Patients treated with laparoscopic uterine artery occlusion is good toleration,less bleeding,little inflammatory and low recurrence rate during the period of following-up,which is worthy of application.