| 金 波,李玉萍,李淑萍,杨瑞娟,张 婷.腹腔镜下子宫血管阻断术联合子宫肌瘤剜除术治疗子宫肌瘤的回顾性研究[J].,2022,(17):3324-3328 |
| 腹腔镜下子宫血管阻断术联合子宫肌瘤剜除术治疗子宫肌瘤的回顾性研究 |
| Retrospective Study of Laparoscopic Uterine Vascular Occlusion Combined with Hysteromyoma Enucleation in the Treatment of Hysteromyoma |
| 投稿时间：2022-02-26 修订日期：2022-03-21 |
| DOI：10.13241/j.cnki.pmb.2022.17.024 |
| 中文关键词: 子宫肌瘤 腹腔镜 子宫血管阻断术 子宫肌瘤剜除术 回顾性研究 |
| 英文关键词: Hysteromyoma Laparoscope Uterine vascular occlusion Hysteromyoma Enucleation Retrospective study |
| 基金项目:福建省医学创新课题项目（2017-CXB-31） |
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| 中文摘要: |
| 摘要 目的：回顾性分析子宫肌瘤剜除术联合腹腔镜下子宫血管阻断术治疗子宫肌瘤的临床疗效。方法：分析2017年6月~2019年7月期间我院收治的子宫肌瘤患者的临床资料（n=150）。根据手术方法的不同将患者分为A组（腹腔镜下子宫肌瘤剜除术治疗，73例）和B组（腹腔镜下子宫血管阻断术联合子宫肌瘤剜除术治疗，77例），对比两组术中、内分泌激素、术后恢复指标、妊娠情况、并发症发生率及复发率。结果：两组患者手术时间对比无统计学差异（P>0.05），B组的术中出血量少于A组，术后排气时间、住院天数、下床活动时间短于A组（P<0.05）。A组术前、术后3个月、术后6个月黄体生成素(LH) 、卵泡刺激素(FSH) 、雌二醇(E2) 水平组内对比无统计学差异（P>0.05）。B组术前、术后3个月、术后6个月E2水平呈降低后升高趋势，LH、FSH水平呈升高后降低趋势（P<0.05）。B组术后3个月LH、FSH水平高于A组，E2水平低于A组（P<0.05）。与A组相比，B组的并发症发生率明显下降，组间对比有差异（P<0.05）。B组的妊娠率高于A组，子宫肌瘤复发率低于A组（P<0.05）。两组流产率组间对比无统计学差异（P>0.05）。结论：与单纯子宫肌瘤剜除术相比，结合腹腔镜下子宫血管阻断术治疗子宫肌瘤患者可减少术中出血量，促进患者术后恢复，降低并发症发生率及复发率，虽然其对卵巢功能有轻微、短暂性影响，但可逐步恢复，且有利于提高妊娠率。 |
| 英文摘要: |
| ABSTRACT Objective: To retrospectively analyze the clinical efficacy of laparoscopic uterine vascular occlusion combined with hysteromyoma enucleation in the treatment of hysteromyoma. Methods: The clinical data of patients with hysteromyoma who treated in our hospital from June 2017 to July 2019 were analyzed (n=150). According to different surgical methods, the patients were divided into group A (laparoscopic hysteromyoma enucleation treatment, 73 cases) and group B (laparoscopic uterine vascular occlusion combined with hysteromyoma enucleation treatment, 77 cases). The intraoperative, endocrine hormones, postoperative recovery indexes, pregnancy situation, complication rate and recurrence rate were compared between the two groups. Results: There was no statistical difference in the operative time between the two groups (P>0.05), the intraoperative blood loss in group B was less than that in group A, and the postoperative exhaust time, hospitalization days and out of bed activity time were shorter than those in group A (P<0.05). There were no significant differences in the levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2) in group A at before surgery, 3 months after surgery and 6 months after surgery (P>0.05). In group B, the level of E2 decreased and then increased before surgery, 3 months after surgery and 6 months after surgery, while the levels of LH and FSH increased and then decreased (P<0.05). The levels of LH and FSH in group B were higher than those in group A, and the level of E2 was lower than that in group A at 3 months after surgery (P<0.05). Compared with group A, the complication rate in group B was significantly decreased, and the difference between groups was statistically significant (P<0.05). The pregnancy rate in group B was higher than that in group A, and the recurrence rate of hysteromyoma was lower than that in group A (P<0.05). There was no significant difference in abortion rate between the two groups (P>0.05). Conclusion: Compared with simple hysteromyoma enucleation, the treatment of hysteromyoma patients combined with laparoscopic uterine vascular occlusion can reduce the intraoperative blood loss, promote the postoperative recovery of patients, and reduce the complication rate and recurrence rate. Although it has a slight and transient impact on ovarian function, it can recover gradually and improve the pregnancy rate. |
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