腹腔镜下子宫肌瘤切除术制约因素的实验研究

目的：探讨腹腔镜下子宫肌瘤切除术的制约因素。方法：选择子宫单发及多发壁间肌瘤各60例,每组各30例分别局部注射催产素及电凝双侧子宫动脉主干辅助止血后在阴式彩超监测下行子宫肌瘤切除术,对比评价其效果。结果：两种辅助止血方法后切除子宫肌瘤,手术时间差异无显著性;术中出血量,催产素辅助止血组显著多于子宫动脉阻断止血组;电凝子宫动脉主干辅助止血组术前及术后3个月监测卵巢功能无明显影响。结论：术中阴式彩超监测切除子宫肌瘤从根本上降低了手术后的残留及复发;电凝子宫动脉主干止血方法优于催产素辅助止血方法;子宫动脉阻断后,腹腔镜下子宫肌瘤切除术可不再考虑肌瘤部位对手术的制约,对卵巢功能是安全的。

Experimental Research on the Restrict Factors for Laparoscopic Myomectomy

Objective：To investigate the restrict factor of laparoscopic myomectomy.Methods：Sixty cases with single and multiple uterine intramural myoma were divided into two groups.In order to reduce bleeding,30 cases were locally injected oxytocin and the uterine arteries of other 30 cases were coagulated,then all cases were undergone laparoscopic myomectomy by vaginal ultrasound-assisted,at last the effectiveness of two groups were compared and evaluated.Results：The operative time had no significant difference between two groups.The blood loss in oxytocin injection group was significantly more than that of uterine artery occlusion group;the coagulation of main branch of uterine artery had no effect on ovarian function pre-or after-operative 3 months.Conclusion：The removal of uterine fibroids by vaginal ultrasound-assisted radically reduces the residual and recurrence of uterine fibroids after surgery;electric coagulation of uterine artery significantly reduces the operative bleeding compared with the oxytocin injection group.After blocking uterine artery,we may no longer consider the constraints of myoma site for the operation during laparoscopic myomectomy;the uterine artery occlusion is safe for ovarian function in myomectomy.