“肌壁大部切除-子宫重建术”治疗中、重度子宫腺肌病的术式与安全性探讨

Surgery and safety exploration on treatment of adenomyosis by major uterine wall resection and reconstruction of the uterus

目的探讨"肌壁大部切除-子宫重建术"治疗中、重度子宫腺肌病的安全性和手术相关问题。方法采用MURU治疗32例中、重度子宫腺肌病患者,对MURU手术方式,手术时间、出血量、并发症及手术效果进行观察、分析。结果 32例病人MURU均获成功,平均手术时间、出血量、住院时间分别为:85.56±25.34 min、61.27±25.47 mL、4.60±0.57 d。术前病人子宫平均体积:268.52±98.75 cm3;切除子宫肌壁的平均重量、体积分别为:315.45±72.36 g、282.43±151.67 cm3。与正常育龄妇女子宫比较,MURU术后子宫平均体积缩小约4.28倍;切除肌壁的重量为正常子宫重量的5.28倍。结论 MURU安全性好,手术切除范围广泛,可用于中、重度子宫腺肌病保留子宫治疗的研究。

Objective To explore the clinical safety and therapeutic effects of major uterine wall resec- tion and reconstruction of the uterus （MURU） on the moderate and severe adenomyosis. Methods Thirty -two patients with moderate or severe adenomyosis were selected. The operation pattern and time, the bleeding amount, complications and surgery efficacy were investigated and analyzed. Results Thirty - two patients were successfully treated with MURU. The average operation time, bleeding amount and hospital duration were 85.56 _± 25.34 min, 61.27 ± 25.47 mL and 4.60 ± 0.57 d, respectively. The average uterine volumes before MURU were 268.52 ± 98.75 cm3. The mean weight and volumes of the resected uterine walls by MURU were 315.45 ± 72.36 g and 282.43 ± 151.67 cm3, respec- tively. Compared with the normal uterus in gestational age, the average uterine volumes were reduced a- bout 4.28 times and the weight of the resected uterine walls was increased 5.28 times after MURU. Conclusion MURU could be safely used in the treatment of moderate and severe adenomyosis with uterus reserving therapy.