阴道超声在腹腔镜子宫肌瘤剔除术中对减少肌瘤残留及降低肌瘤复发的价值*

目的探究分析阴道超声应用于腹腔镜子宫肌瘤剔除术中对于减少肌瘤残留及降低肌瘤复发的运用价值。方法选择该院收治的120名进行了腹腔镜子宫肌瘤剔除术的患者,根据患者的入院时间随机分为观察组和对照组,两组患者都在腹腔镜下进行手术,观察组在手术时配合使用阴道超声,继续剔除残存的子宫肌瘤,术后对两组患者进行12个月的随访。记录两组患者在手术中的各项指标、术后肌瘤残存的情况以及术后12个月肌瘤的复发情况等数据。结果观察组的治疗时间、术中出血量、术后排气时间和住院时间与对照组相比,差异无统计学意义(P0.05)。观察组共出现1例血肿、1例输尿管损伤、2例膀胱损伤和1例直肠损伤;对照组共出现1例血肿、1例膀胱损伤、2例切口感染和2例直肠损伤。比较两组的术中并发症发生率,差异无统计学意义(P0.05)。观察组的肌瘤平均直径明显小于对照组,差异有统计学意义(P0.05)。观察组仅4例患者出现肌瘤残存明显小于对照组患者出现的21例,差异有统计学意义(P0.05)。观察组患者在术后9和12个月的时候各出现了1例复发情况,而对照组在术后3、6、9和12个月分别出现了1、2、5和7例复发,观察组患者出现病情复发的情况明显少于对照组,差异有统计学意义(P0.05)。结论使用阴道超声对接受腹腔镜子宫肌瘤剔除术的患者中引导剔除残存的肌瘤,能明显减少肌瘤的残留,值得在临床上推广。

Transvaginal ultrasound in laparoscopic myomectomy for reduction of residual myoma and reduction of fibroid recurrence*

Abstract: Objective To explore the application of vaginal ultrasound in laparoscopic myomectomy for the reduction of fibroid residue and reduce the recurrence of fibroids value. Methods 120 patients were randomly divided into observation group and control group according to the patient’s admission time, all the patients received laparoscopic surgery, while the observation group operation was cooperated with vaginal ultrasound continued to eliminate the remaining uterine fibroids. After operation, all the patients were followed up for 12 months. The operation of the two groups was observed, the remnants of postoperative myoma and the recurrence of myoma at 12 months after the operation were recorded. Results The observation group’s treatment time, blood loss, postoperative exhaust time and hospital stay compared with the control group had no significant difference (P > 0.05). One case of hematoma, one case of ureteral injury, two cases of bladder injury and one case of rectal injury occurred in the observation group. One case of hematoma, one case of bladder injury, two cases incision infection and two cases of rectal injury occurred in the control group. Comparing the incidence of intraoperative complications between the two groups show no significant difference (P > 0.05). The average diameter of fibroids in the observation group was significantly smaller than that in the control group (P < 0.05). In the observation group, only 4 patients showed fibroid remnants that were significantly smaller than those in the control group (P < 0.05). One case of recurrence occurred in the observation group at 9 months and 12 months after operation, while in the control group, at 3, 6, 9, and 12 months after the operation 1, 2, 5, and 7 cases recurred, respectively. The patients in the observation group had a significantly lower incidence of recurrence than those in the control group (P < 0.05). Conclusion The use of colposcopy in patients underwent laparoscopic myomectomy to guide the removal of residual fibroids can significantly reduce the residual fibroids, it is worth to clinically promote.