垂体后叶素结合腹腔镜肌瘤假包膜套扎法治疗壁间肌瘤的临床分析

Clinical analysis of vasopressin combined with loop ligation of paeudocapsule for intramural myomas laparoscopic myomectomy

目的探讨垂体后叶素结合腹腔镜下肌瘤假包膜套扎及镜下连续缝合技术在治疗子宫肌壁间肌瘤中的临床价值。方法回顾性分析2011年1月至2012年7月在我科住院的66例采用肌瘤假包膜套扎法和同期50例传统缝合行腹腔镜子宫肌瘤剔除术治疗肌壁间肌瘤患者的临床资料。比较两组的手术时间、术中出血量、并发症、术后恢复情况及子宫瘢痕愈合情况等。结果两组的手术时间、并发症及术后恢复情况差异无统计学意义,而肌瘤假包膜套扎组的术中出血量为(57.35±9.87)mL,明显少于传统缝合组(210.50±14.56)mL(P<0.001);术后(30±5)d子宫瘢痕减小指数,肌瘤假包膜套扎组为73.50%±3.46%,传统缝合组为64.56%±4.08%,两组比较差异具有统计学意义(P<0.001)。结论采用垂体后叶素结合肌瘤假包膜套扎及镜下连续缝合方法行腹腔镜子宫肌瘤剔除术疗效显著,尤其适用于肌壁间肌瘤,相对于传统缝合法,可减少术中出血,术后子宫瘢痕愈合快,具有一定的临床价值。

Objective To evaluate the clinical value of laparoscopic myomectomy （LM） during vasopressin combined with loop ligation treatment for intramural myomas. Methods LM with both loop ligation of paeudocapsule and definite endoscopic suturing was performed in 66 cases of intramural myomas, meanwhile, 50 patients underwent traditional LM. Retrospective analysis was carried out to examine the clinical parameters of LM with both loop ligation of paeudocapsule and definite endoscopic suturing, such as operative time, blood loss, complications, postoperative recovery and uterine wound healings. Results LM with both loop ligation of paeudocapsule and definite endoscopic su turing were similar to traditional LM in operative time, complications and postoperative recovery. The blood loss and postoperative uterine wound healings of LM with both loop ligation of paeudocapsule group was better than those of tra ditional LM group respectively E （57 35± 9.87 ） mL vs. （ 210. 50 ±14. 56 ） mL, P 〈 0. 001 ± E （73.50% ± 3.46% ） vs. （64. 56% ± 4. 08% ）, P 〈 0. 0011 Conclusion LM with both loop ligation of paeudocapsule and definite endoscopic suturing treatment for intramural myomas offers significant advantages, especially in lower blood loss and faster uterine wound healing.