腹腔镜下病灶挖除术治疗子宫腺肌病的临床研究

Clinical study on laparoscopic surgery of adenomyoma excision

目的探讨腹腔镜下病灶挖除术治疗子宫腺肌病的可行性及临床疗效。方法选择2006年6月～2009年12月该院收治子宫腺肌病患者56例,行腹腔镜下病灶挖除术,观察患者术前及术后1、3及6个月痛经的改善情况、子宫体积、血红蛋白、血清CA125、EMAb水平的变化。结果术后1个月50例(91.0%)患者痛经症状消失或明显缓解,术后3个月49例(87.5%)患者症状消失或明显缓解,术后6个月时有45例(80.3%)患者症状消失或明显缓解。术后1、3及6个月56例患者血红蛋白水平逐渐升高,明显高于术前水平(P<0.01);血清CA125水平及血清EMAb阳性率与术前比较,差异均有显著性(P<0.01);超声提示子宫体积均较术前体积明显缩小,差异有显著性(P<0.05)。结论腹腔镜下病灶切除术治疗子宫腺肌病的近期疗效明显,创伤小,患者恢复快,适合年轻、希望保留子宫的患者。

[Objective] To evaluate the efficiency and application value of laparoscopic surgery of adenomyoma excision in treatment of adenomyoma. [Methods] 56 patients with adenomyoma treated with laparoscopic surgery of adenomyoma excision were selected. The difference before and after treatment at 1, 3, 6 month in relief of symptoms of dysmenorrheal, uterine volumes, the levels of Hb, serum CA125 and EMAb were observed. [Results] One month after surgery, dysmenorrhea of 50% patients was disappeared or relief, 87.5% three months postoperative and 80.3% six months postoperative. After one, three, six months postoperative, the levels of Hb increased significantly, the levels of serum CA125, EMAb and uterine volumes decreased significantly compared with before treatment. [Conclusions] Laparoscopic surgery of adenomyoma excision is effective, less trauma and rapid recovery. It could be recommended for those nulliparous young patients with desire of an integrated uterus.