腹腔鏡下電凝阻斷子宮動脈在無生育要求患者子宮肌瘤剔除術中的應用及預后

姚文超 彭繼紅

摘? ?要：目的? 探討腹腔鏡下電凝阻斷子宮動脈在子宮肌瘤剔除術中的應用及預后。方法? 對2009年2月～2011年2月來我院因子宮肌瘤行肌瘤剝除手術治療的住院患者共83例，按照隨機數字表法將患者分為實驗組和對照組，實驗組41例先行腹腔鏡下子宮動脈電凝阻斷再行肌瘤剝除術，對照組42例直接行腹腔鏡下子宮肌瘤剝除術，比較兩組的手術時間、術中出血量、肛門排氣時間、住院時間、并發癥發生率。2年內對所有患者定期隨訪，觀察月經量，B超復查監測肌瘤復發情況。結果? 與對照組比較，實驗組手術時間縮短（109.92±17.52）min vs（84.83±8.63）min，術中出血量減少（163.13±36.42）ml vs（94.42±13.73）ml，差異有統計學意義（P<0.05）;兩組患者的肛門排氣時間（29.64±2.44）h vs（28.84±2.94）h、住院時間（6.53±0.63）d vs（6.23±0.92）d、并發癥發生率7.10% vs 7.30%比較，差異無統計學意義（P>0.05）。隨訪2年，實驗組月經量少于對照組（60.53±17.62）ml vs（133.82±32.53）ml，差異有統計學意義（P<0.05）。實驗組肌瘤無1例復發，對照組子宮肌瘤有6例復發，實驗組復發率（0%）優于對照組（14.30%），差異有統計學意義（P<0.05）。結論? 腹腔鏡下電凝阻斷子宮動脈后再行肌瘤剝除術可有效的減少術中出血量，縮短手術時間，減少術后月經量，降低肌瘤復發率。

關鍵詞：腹腔鏡;子宮肌瘤;子宮動脈阻斷

中圖分類號：R737.33? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻標識碼：A? ? ? ? ? ? ? ? ? ? ? ? ? ? ?DOI：10.3969/j.issn.1006-1959.2018.21.028

文章編號：1006-1959（2018）21-0103-03

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

YAO Wen-chao，PENG Ji-hong

（Department of Obstetrics and Gynecology，Liyang Branch，Jiangsu Hospital of Traditional Chinese Medicine，

Liyang 213300，Jiangsu，China）

Abstract：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.