腹腔镜子宫腺肌瘤切除术的临床体会

目的:探讨腹腔镜子宫腺肌瘤切除术联合孕三烯酮或达菲林的疗效、安全性及应用价值。方法:为46例因月经增多、经期延长、痛经、不孕患者行腹腔镜手术,术前经妇科检查、B超检查临床诊断为子宫腺肌瘤,患者均要求保留子宫,术后予以孕三烯酮或达菲林治疗。结果:46例患者中2例镜下未见突起病灶,未进一步手术;手术时间平均(65.1±5.3)min,术中出血量平均(50.3±4.6)ml,肛门排气时间平均(10±4.3)h,术后平均住院5 d。术后12例联合应用孕三烯酮,32例使用达菲林治疗,痛经缓解率86.7%以上,月经改善率97.4%。结论:腹腔镜子宫腺肌瘤切除术联合孕三烯酮或达菲林治疗子宫腺肌瘤可有效缓解临床症状,减少复发,保留患者的生育器官。

Clinical experience of laparoscopic adenomyoma resection

Objective:To discuss the effect,safety and value of laparoscopic adenomyoma resection combined with gestrinone or triptorelin.Methods:Forty-six patients who suffered from menorrhagia,bradymenorrhea,algomenorrhea or infertility and diagnosed as adenomyoma by gynecological examination and B-ultrasound underwent laparoscopic adenomyoma resection,then accepted postoperative treatment of gestrinone or triptorelin.All patients desired to reserve their uteri.Results:Forty-four patients underwent successful laparoscopic adenomyoma resection.No lesions were found in 2 patients.In the 44 cases,the mean time of surgery was(65.1±5.3) min,average blood loss was(50.3±4.6) ml,average time of evacuation was(10±4.3) h,and average time of postoperative hospital stay was 5 d.After operation,12 cases were given gestrinone and 32 cases triptorelin.The postoperative remission rate of dysmenorrhea was above 86.7% and improvement of menstruation was 97.4% in the 44 cases.Conclusions:Laparoscopic adenomyoma resection combined with gestrinone or triptorelin for adenomyoma can effectively relieve symptoms,reduce recurrence,and preserve patients’ reproductive organs.