腹腔镜下阻断子宫动脉后子宫肌瘤切除术126例临床分析

目的:探讨腹腔镜下子宫动脉阻断后行肌瘤切除治疗子宫肌瘤的临床效果。方法:对126例要求保留子宫的子宫肌瘤患者采用腹腔镜下双侧子宫动脉上行支阻断后行肌瘤切除术,与腹腔镜下采用子宫肌层注射缩宫素后子宫肌瘤切除术比较,分析手术时间、术中出血量,术后血肿形成,定期随访观察月经量,B超检查监测肌瘤复发情况,并将两组进行对照比较。结果:研究组平均手术时间(83.7±29.5)min,与对照组(93.5±32.2)min相近;术中出血量(78.5±35.2)ml,明显少于对照组(150.3±50.5)ml;研究组术后无1例血肿形成,对照组有2例;两组随访1年,研究组月经量(50±20.8)ml,明显少于对照组月经量平均(120±50.5)ml,肌瘤复发率1.5%,明显低于对照组18.2%。结论:腹腔镜下子宫动脉阻断后行肌瘤切除术治疗子宫肌瘤与腹腔镜下采用子宫肌层注射缩宫素后子宫肌瘤切除术相比较,能明显减少术中出血,缓解月经过多,延缓肌瘤复发,具有一定的临床应用价值。

Clinical analysis of 126 cases underwent laparoscopic myomectomy after uterine artery occlusion

Objective To evaluate the clinical effects of laparoscopie myomeetomy after uterine artery occlusion. Method For 126 patients of hysteromyoma requesting remaining uterus were treated with laparoseopie myomectomy after ascending branch of bilateral uterine artery occlusion, and compared with those underwent laparoscopie myomectomy after uterine muscle injecting oxytocin. The operative time, blood loss during operation, postoperative hematoma formation, regular follow - up of menstrual flow and B - ultrasound monitoring of hysteromyoma recurrence were compared between the two groups. Results The mean operative time of the study group was （ 83.7 ± 29.5 ） min,similar to the control group （93.5 ± 32.2） min; blood loss during operation was （78.5 ± 35.2） ml, significantly less than the control group （ 150. 3 ± 50. 5） ml;no postoperative hematoma formation was found in the study group,2 cases in the control group;after one -year follow - up, menstrual volume in the study group was （ 50 _＋ 20. 8 ） ml, significantly less than the control group （ 120 _＋ 50. 5 ） ml, the hysteromyoma recurrence rate was 1.5% ,significantly lower than the control group （ 18.2% ）. Conclusion Compared with laparoseopic myomectomy after uterine muscle injecting oxytocin,laparoscopic myomectomy after uterine artery occlusion can significantly reduce the bleeding during operation, avoid menorrhagia, delay hysteromyoma recurrence, with value of clinical application.