腹腔镜下年轻女性变性子宫肌瘤诊治23例报告

Laparoscopic Diagnosis and Treatment of Degenerated Uterine Leiomyoma in Young Women: Report of 23 Cases

目的探讨腹腔镜下年轻女性变性子宫肌瘤的诊断及治疗。方法我院2007年3月～2011年1月腹腔镜诊治变性肌瘤23例,直径5～7 cm,术前诊断5例,术中探查发现18例,23例均行腹腔镜下子宫肌瘤剔除术。结果腹腔镜下肌瘤剔除术顺利,无一例中转开腹,无周围脏器副损伤。手术时间(80±24)min,术中出血量(107.5±67.5)ml。23例肌瘤变性经术中快速或术后病理学明确诊断:玻璃样变14例,囊性变5例,红色变3例,钙化1例。23例随访2年,无异常阴道出血及腹痛等不适,复查B超无盆腔积液及盆腔包块,其中9例正常受孕。结论腹腔镜下探查、诊治变性子宫肌瘤,同时行肌瘤剔除术是可行的。

Objective To investigate the laparoscopic diagnosis and treatment of uterine fibroids degeneration in young women. Methods From 2007 March to 2011 January,we performed laparoscopic exploration on 498 patients in our hospital;of the patients,23 cases of fibroid degeneration（5-7 cm in diameter） were detected（5 of the cases were diagnosed before the operation,and the other 18 were confirmed during the procedure）.Laparoscopic myomectomy was carried out in these 23 patients.Results The procedure was completed in all the 23 cases without conversion to open surgery,nor injuries to adjacent organs.The mean operation time was（80±24） min,and intraoperative blood loss was（107.5±67.5） ml.Fast-frozen of postoperative pathological examination showed hyaline degeneration in 14 cases,cystic degeneration in 5,red degeneration in 3,and calcification in 1.The patients were followed up for 2 years,during which no patients complained of abnormal vaginal hemorrhage or abdominal pain;reexamination by B-ultrasonography showed no pelvic fluid or mass;and 9 of the patients were pregnant normally.Conclusion Laparoscopic exploration is feasible for diagnosing degeneration of uterine fibroid,and myomectomy can be performed simultaneously.