腹腔镜和射频消融术治疗子宫肌瘤的临床观察

Clinical Observation of Laparoscopic Radiofrequency Ablation in Treatment of Uterine Fibroids

目的:观察子宫肌瘤患者予以射频消融术及经腹腔镜行肌瘤剔除术治疗的临床效果。方法:对我院自2008年11月至2011年11月以来,于我科治疗的252例子宫肌瘤患者临床资料进行回顾性分析,将其随机分为AB两组,每组患者126例,A组应用射频消融术,B组经腹腔镜行肌瘤剔除术,对比观察两组术中的出血量与手术的时间及住院的时间,在半年后予以复查B超,了解两组患者子宫的大小与形态,并随访两组有生育要求患者的妊娠情况。结果:AB两组患者术中的出血量对比,呈显著差异(P<0.05);AB两组患者手术的时间对比,呈显著差异(P<0.05)。A组患者均无须住院,在手术结束后仅观察2至4小时即能够离院,AB两组患者术后的住院时间对比,呈显著差异(P<0.05)。B组96例有生育要求,A组84例有生育要求,B组一年内有90例受孕(约93.75%),A组一年内有50例受孕(约59.52%),两组相较,呈显著差异(P<0.05)。结论:子宫肌瘤患者应用LM与RF治疗均能够达到治愈目的。而黏膜下肌瘤及肌壁间肌瘤(凸向宫腔)能够降低患者的自然受孕率及胚胎种植率(体外受精),但LM治疗后患者妊娠率能够提高,并且有效、安全、微创,应该作为有生育要求患者的首选;RF治疗的时间较短,不仅术中出血少,而且术后恢复快,同时医疗费用也较低,可作为无生育要求患者的参考。

Objective：Observed in patients with uterine fibroids be the clinical effect of radiofrequency catheter ablation by laparoscopic myomectomy.Methods：Were retrospectively analyzed the clinical data of patients of the hospital since November 2008 to November 2011,in the treatment of our department,252 cases of uterine fibroids were randomly divided into AB two groups,each group of patients with 126 cases,group Aapplication of radiofrequency ablation,group B of laparoscopic myoma excluding surgery,the amount of contrast were observed intraoperative bleeding and the time of surgery and hospitalization time,be in the six months after the review B,the size of two groups of patients with endometriosisshape,and follow-up in two groups the fertility requirements of the patient＇s pregnancy.Results：Contrast AB two groups of patients with intraoperative blood loss was significantly different（P0.05）;AB,two sets of times for surgery in patients with contrast showed a significant difference（P0.05）.Group A were not hospitalized,only observed 2-4 hours from hospital after surgery,comparison of the AB,two groups of patients the hospital stay,was significantly different（P0.05）.Group B,96 cases of childbearing,fertility in group A and 84 cases,90 cases of pregnancy（93.75%） in group B within one year,50 cases of pregnancy（59.52%） in group A within one year,compared with two groups was significant difference（P0.05）.Conclusion：Uterine fibroids in patients with LM and RF treatment were able to achieve the purpose of cure.Submucosal fibroids and intramural fibroids（convex to the uterine cavity） can reduce the patient＇s natural conception rate and embryo implantation rate（IVF）,but the LM treatment in patients with pregnancy rate can improve,and effective,safe,minimally invasive should be used as fertility requirements of the patient＇s preferred;RF treatment time is shorter,not only less bleeding,and rapid postoperative recovery,while medical costs are lower,can be used as fertility requirements of patients with reference.