腹腔镜下电凝阻断子宫动脉在无生育要求患者子宫肌瘤剔除术中的应用及预后

目的 探讨腹腔镜下电凝阻断子宫动脉在子宫肌瘤剔除术中的应用及预后。方法 对2009年2月~2011年2月来我院因子宫肌瘤行肌瘤剥除手术治疗的住院患者共83例，按照随机数字表法将患者分为实验组和对照组，实验组41例先行腹腔镜下子宫动脉电凝阻断再行肌瘤剥除术，对照组42例直接行腹腔镜下子宫肌瘤剥除术，比较两组的手术时间、术中出血量、肛门排气时间、住院时间、并发症发生率。2年内对所有患者定期随访，观察月经量，B超复查监测肌瘤复发情况。结果 与对照组比较，实验组手术时间缩短（109.92±17.52）min vs（84.83±8.63）min，术中出血量减少（163.13±36.42）ml vs（94.42±13.73）ml，差异有统计学意义（P＜0.05）；两组患者的肛门排气时间（29.64±2.44）h vs（28.84±2.94）h、住院时间（6.53±0.63）d vs（6.23±0.92）d、并发症发生率7.10% vs 7.30%比较，差异无统计学意义（P＞0.05）。随访2年，实验组月经量少于对照组（60.53±17.62）ml vs（133.82±32.53）ml，差异有统计学意义（P＜0.05）。实验组肌瘤无1例复发，对照组子宫肌瘤有6例复发，实验组复发率（0%）优于对照组（14.30%），差异有统计学意义（P＜0.05）。结论 腹腔镜下电凝阻断子宫动脉后再行肌瘤剥除术可有效的减少术中出血量，缩短手术时间，减少术后月经量，降低肌瘤复发率。

Application and Prognosis of Laparoscopic Electrocoagulation for Uterine Artery Removal in Patients with Uterine Fibroids without Fertility Requirements

Objective To investigate the application and prognosis of laparoscopic electrocoagulation for uterine artery removal in uterine fibroids. Methods A total of 83 inpatients who underwent fibroidectomy in our hospital from February 2009 to February 2011 were enrolled. The patients were divided into experimental group and control group according to the random number table method.In the experimental group, 41 cases underwent laparoscopic uterine artery electrocoagulation to block the myomectomy, and 42 patients in the control group underwent laparoscopic uterine fibroids removal. The operation time and intraoperative blood loss were compared between the two groups. Anal exhaust time, hospital stay, and complication rate. All patients were followed up regularly within 2 years to observe the menstrual volume, and B-ultrasound was used to monitor the recurrence of fibroids. Results Compared with the control group, the operation time of the experimental group was shortened (109.92±17.52) min vs (84.83±8.63) min, and the intraoperative blood loss was reduced (163.13±36.42) ml vs (94.42±13.73) ml,the difference was statistically significant (P<0.05);The anus exhaust time (29.64±2.44) h vs (28.84±2.94) h, hospitalization time (6.53±0.63) d vs (6.23±0.92) d, and the complication rate of 7.10% vs 7.30% in the two groups were compared,the difference was not statistically significant (P>0.05). After two years of regular follow-up, the menstrual volume of the experimental group was less than that of the control group (60.53±17.62) ml vs (133.82±32.53) ml,the difference was statistically significant (P<0.05). There was no recurrence of fibroids in the experimental group, and 6 cases of uterine fibroids in the control group recurred. The recurrence rate of the experimental group (0%) was better than that of the control group (14.30%),the difference was statistically significant (P<0.05). Conclusion Laparoscopic electrocoagulation to block the uterine artery and then undergoing myomectomy can effectively reduce the intraoperative blood loss, shorten the operation time, reduce the postoperative menstrual flow and reduce the recurrence rate of fibroids.