腹腔镜下不同术式子宫肌瘤切除术51例分析

Clinical analysis of different laparoscopic techniques for hysteromyomectomy in 51 cases

目的评估腹腔镜下不同术式治疗子宫肌瘤的效果。方法选择2004年1月至2010年7月在成都市第五人民医院妇产科住院的51例子宫肌瘤患者,其中浆膜下肌瘤14例,肌壁间肌瘤28例,阔韧带肌瘤9例;肌瘤直径(diameter,d)平均约6.2cm(3～18cm),其中d<5cm17例(33.33%),d≥5cm34例(66.67%);单发肌瘤24例(47.06%),多发肌瘤27例(52.94%)。根据患者本人保留子宫的意愿及肌瘤的大小、位置、生育要求分别采用不同术式行腹腔镜子宫肌瘤切除术。结果子宫肌瘤切除术14例,子宫动脉结扎及子宫肌瘤切除术20例,子宫动脉临时阻断及子宫肌瘤切除术17例,所有病例腹腔镜手术均成功,无手术并发症及术后并发症。结论根据不同的病例特点和要求,运用不同的术式,在腹腔镜下行子宫肌瘤切除术可取得满意的临床疗效。

Objective To evaluate the effects of different laparoscopic techniques for hysteromyomectomy.Methods Totally 51 inpatients with uterus myoma including subserous fibroids in 14 cases,intramural fibroids in 28 cases and broad ligament fibroids in 9 cases were chosen in this study from January 2004 to July 2010 in Department of Obstetrics and Gynecology,Chengdu the Fifth People＇s Hospital.The average diameter of the fibroids was 6.2 cm（3~18 cm）.The diameter of the fibroids less than 5 cm was found in 17 patients（33.33%）,but equal to or larger than 5 cm in 34 patients（66.67%）.The single myoma was found in 24 patients（47.06%）,but numerous myomas in 27 patients（52.94%）.The cases were taken Hysteromyomectomy with different methods according to the size and location of myomas,patient＇s birth demand.Results Hysteromyomectomy,hysteromyomectomy and uterine artery blockage,hysteromyomectomy and temporary uterine artery blockage were performed on 14,20,and 17 patients respectively.Operations were successful in all patients.The intra-and post-operative complications were not observed.Conclusion Satisfied clinical outcomes could obtain through different laparoscopic approaches by hysteromyomectomy in different case with different properties,requirements and consideration.