腹腔镜下子宫动脉阻断术辅助子宫肌瘤挖除术对患者生育功能及肌瘤复发率的影响

目的探讨腹腔镜下2种子宫动脉阻断方法对子宫肌瘤患者生育功能及肌瘤复发率的影响。方法选择2006年1月1日至2008年11月8日重庆市妇幼保健院患者和西南医院子宫肌瘤患者164例,根据手术方式分为3组:腹腔镜子宫动脉永久阻断术(PAB)组(n=64)行PAB加子宫肌瘤挖除术(LM);腹腔镜子宫动脉临时阻断术(TAL)组(n=50)行TAL加LM;对照组(n=50)行腹腔镜子宫肌瘤挖除术。比较3组患者术后复发、妊娠和生育情况。结果术中失血量PAB组和TAL组明显少于对照组(P<0.05);肌瘤复发率PAB组明显低于TAL组和对照组(P<0.05)。结论 PAB能降低子宫肌瘤复发率;TAL对生育功能无影响,但不能降低子宫肌瘤复发率。

Effect of laparoscopic uterine arterial blocking and myomectomy on fertility and myoma recurrence

Objective To evaluate the effect of 2 types of uterine arterial ligation before myomectomy on the fertility and the myoma recurrence.Methods 164 patients with uterine myoma treated by laparoscopy were classified into 3 groups according to the operative modes.The PAB group(64 cases) received uterine arterial permanent uterine artery blocking(PAB) before uterine myomectomy and the TAL group(50 cases) received transient uterine arterial ligation(TAL) before uerine myomectomy and the control group(50 cases) received laparoscopic myomectomy without uterine artery ligation.Postoperative recurrence of myoma,pregnancy and fertility were compared among 3 groups.Results Intraoperative blood loss in the PAB and TAL groups was significantly less than that in the control group(P<0.05).The recurrence rate of myoma in the PAB group was obviously lower than that in the TAL group and control group(P<0.05).Conclusion PAB could decrease the recurrence rate of myoma;TAL is no effect on fertility function,but can not decrease the recurrence rate of myoma.