子宫动脉上行支阻断在腹腔镜下子宫肌瘤剔除术中的应用

目的 探讨子宫动脉上行支阻断在腹腔镜下子宫肌瘤剔除术中的应用价值.方法 选取2005年1月～2006年6月在我院住院,要求行腹腔镜下子宫肌瘤剔除术的患者(排除宫颈肌瘤、阔韧带肌瘤及黏膜下子宫肌瘤)60例,随机分为观察组和对照组各30例,观察组患者在行子宫肌瘤剔除前先行子宫动脉上行支阻断,对照组直接行子宫肌瘤剔除术.观察两组手术时间、术中出血情况、术后恢复情况(如术后排气时间、切口愈合情况、住院时间等),门诊随访观察子宫肌瘤复发及月经改善情况.结果 60例患者均在腹腔镜下行子宫肌瘤剔除术,无中转开腹.观察组术中出血量明显少于对照组,与对照组相比差异有显著统计学意义(P＜0.01);手术时间和术后排气时间,观察组小于对照组,差异有统计学意义(P＜0.05);平均住院日两组比较无明显差异(P＞0.05).两组患者均无切口愈合不良发生(0/60).观察组术后月经过多改善率为100%(26/26),而对照组则为80%(16/20),差异有统计学意义(P＜0.05).结论 子宫动脉上行支阻断可明显减少腹腔镜下子宫肌瘤剔除时的手术出血量,术后恢复快,症状改善率高,且不增加手术并发症,具有临床推广应用价值.

Application of Blocking Ascending Branch of Uterine Arteries in Operation of Hysteromyomas Rejecting by Laparoscope

Objective To investigate blocking ascending branch of uterine arteries in operation of hysteromyomas rejecting by laparoscope.Methods 60 petients(except cervix myoma,intraligamentary myoma,submucosa myoma),randomly devided to reseach group(30 cases)and control group(30 cases).Blocking ascending branch of uterine arteries before rejecting hysteromyomas by laparoscope in reseach group,directly rejecting hysteromyomas by laparoscope in control group.The volumes of blood loss in operation,the duration of operation,postoperative recovery(Time of passing flatus,wound healing,length of stay)were compared between two groups.During the follow-up months,observing hysteromyoma recidivism and improvement of menstruation.Results All patient were rejected hysteromyomas by laparoscope.The volumes of blood loss in research group were less than that in control group(P<0.01),the duration of operation and postoperative passing flatus were less than that in control group too(P<0.05).There was no significant difference in the mean length of stay(P>0.05),All wounds were well healed in both groups,the rate of hypermenorrhea improvement was 100%(26/26)in research group,but That in control group was 80%(16/20),There was significant difference between two group.Conclusions Blocking ascending branch of uterine arteries may obviously decrease the volumes of blood loss in operation of hysteromyomas rejecting by laparoscope,It presents rapider convalescence,higher rate of symptom improvement and less complication operation.