腹腔镜下子宫腺肌病灶挖除及子宫动脉阻断治疗子宫腺肌病的长期疗效分析

目的探讨腹腔镜下子宫腺肌病灶挖除及子宫动脉阻断术治疗子宫腺肌病的临床疗效及术后血清CAl25、性激素的变化。方法对98例子宫腺肌病患者实施腹腔镜下子宫腺肌病灶挖除及子宫动脉阻断术，对合并有盆腔其他病变术中一并处理：监测术后痛经程度、月经量、血红蛋白、子宫体积及血CAl25、性激素水平。结果98例手术均在腹腔镜下完成，术后经病理检查全部证实为子宫腺肌病，平均随访（26．3＋8．6）个月，患者术后经量均显著减少，贫血及痛经症状改善，子宫体积较术前明显缩小；CAl25水平术后显著下降，性激素水平与术前相比差异无统计学意义。有2例患者术后意外妊娠行人流术，手术经过顺利．无胚物残留及出血等并发症发生。结论腹腔镜下子宫腺肌病灶挖除及子宫动脉阻断治疗子宫腺肌病安全有效．可作为年轻、有保留子宫愿望的患者的治疗选择。

adenomyosis

Objective To investigate the clinical efficacy of laparoscopic cytoreduction of adenomyosis and uterine artery blockage for the treatment of adenomyosis and the changes of the levels of serum CA125 and sexual hormones after operation. Methods Laparoscopic cytoreduction of adenomyosis and uterine artery blockage were performed in 98 patients with adenomyosis. The menstrual volume, dysmenorrhea, serum CA125 level, hemoglobin and sexual hormone levels were monitored after operation. Results All of the 98 cases were operated with laparoscope. During follow-up （26.3＋ 8.6 months）, the menstrual volume was reduced significantly, the symptoms of anemia and dysmenorrheal were relieved and the hemoglobin level returned to normal in all the patients. The level of serum CA125 was reduced significantly after operation. There was no significant difference in sex hormone levels before and after operation. Two cases had induced abortion for unwanted pregnancy. Conclusion laparoscopic cytoreduction of adenomyosis and uterine artery blockage for the treatment of adenomyosis is safe and efficient. It may be an option for young patients who hope to preserve uterus.