腹腔镜下子宫动脉阻断后子宫肌瘤剔除术的临床应用价值

摘要

Objective To study the application value of laparoscopic uterine artery occlusion and uterine myomectomy for uterine myo-mas. Methods The data of 80 patients with uterine myomas in our hospital from January 2011 to January 2015 were studied. They were ran-domly divided into control group and observation group,40 cases in each group. The patients in control group received the laparoscopic myo-mectomy and the patients in observation group were treated by uterine artery occlusion and myomectomy. The hospitalization time,blood loss, disease incidence and recurrence between two groups were compared and analyzed. Results There was no statistically significance in aver-age operative time between two groups(P>0. 05). The exhaust time and hospital stay time in observation group were significantly shorter than those in the control group,the difference were statistically significant(P<0. 05). The blood loss in the control group(145. 2 ± 35. 5) mL was significantly higher than that of observation group(50. 8 ± 21. 6) mL,the difference were statistically significant(χ2 =14. 367 5,P=0. 000 0). The improved rate of postoperative menorrhagia in observation group was 100%, the control group was 25%,the differences were statistically significant(χ2 =4. 599 6,P=0. 032 0). There was no postoperative morbidity and recurrence in observation group. The postoperative morbidi-ty and recurrence rate in the control group were 5 cases (12. 50%) and 11 cases (27. 50%) respectively,the differences between two groups were statistically significant(P<0. 05). Conclusion Laparoscopic uterine artery occlusion combined with uterine myomectomy can reduce blood loss,shorten hospital stay time,reduce postoperative complication and recurrence of uterine myomas.%目的：探讨腹腔镜下子宫动脉阻断后子宫肌瘤剔除术临床应用价值。方法选择2011年1月至2015年1月我院接诊的子宫肌瘤80例患者进行研究。随机分为对照组和观察组,对照组(40例)实施腹腔镜下子宫肌瘤剔除术,观察组(40例)实施腔镜下子宫动脉阻断后子宫肌瘤剔除术,记录分析2组患者手术时间、住院时间、术中出血量、病发率和复发情况。结果2组患者平均手术时间比较,差异无统计学意义(P>0.05)；观察组在排气时间与住院时间上均明显短于对照组,差异具有统计学意义(P<0.05),对照组的术中出血量(145.20±35.50)mL,明显高于观察组(50.80±21.60)mL,差异具有统计学意义(χ2=14.3675, P=0.0000)；观察组术后月经过多改善率达100%,对照组仅为25%,2组比较差异具有统计学意义(χ2=4.5996,P=0.0320)；观察组无术后病率(体温高于38℃)、复发的情况发生,对照组术后病率和复发分别为5例(12.50%)和11例(27.50%),2组患者比较差异具有统计学意义(P<0.05)。结论腹腔镜下子宫动脉阻断后子宫肌瘤剔除可显著降低患者术中出血量,缩短患者住院时间,降低患者术后并发症发生率,对子宫肌瘤的复发起到很好的抑制作用。