腹腔镜子宫肌瘤剔除术联合子宫动脉阻断术在子宫肌瘤患者中的应用价值

Application value of laparoscopic myomectomy combined with uterine artery blockage in patients with uterine fibroids

目的探讨腹腔镜子宫肌瘤剔除术联合子宫动脉阻断术在子宫肌瘤患者中的应用价值。方法回顾性分析本院2010年1月～2012年12月收治的60例子宫肌瘤患者的临床资料，其中行单独腹腔镜子宫肌瘤剔除术治疗的患者30例为对照组。经腹腔镜子宫肌瘤剔除术联合子宫动脉阻断术治疗的患者30例为观察组。比较两组患者的手术时间、术后排气时间、离床活动时间、住院时间、术中出血量、术后恢复情况及术后并发症，同时随访患者6个月，1、2年的肌瘤复发率及月经改善情况。结果两组的手术时间、术后排气时间、离床活动时间、住院时间比较，差异无统计学意义（P〉0．05），而观察组术中出血量、术后并发症均较对照组少（P〈0．05）；观察组随访6个月、1年、2年患者的肌瘤复发率均明显低于对照组，且随访6个月、1年后的月经改善情况优于对照组（P〈0．05），而2年后两组的月经改善情况比较，差异无统计学意义（P〉0．05）。结论腹腔镜子宫剔除术联合子宫动脉阻断术治疗子宫肌瘤临床效果好。不仅损伤小、恢复快，且术中出血量少、术后并发症发生率及复发率均明显降低，月经改善情况良好，值得临床广泛推广。

Objective To investigate the application value of laparoscopic myomectomy combined with uterine artery blockage in patients with uterine fibroids. Methods The clinical data of 60 patients with uterine fibroids in our hospi- tal from January 2010 to December 2012 were retrospectively analyzed,among them,30 cases （the control group） were only terated with laparoscopic myomectomy;the other 30 cases （the observation group） were given laparoscopic my- omectomy combined with uterine artery blockage.The operative time,postoperative exhaust time,ambulation time,hospi- talization time,peri-operative bleeding,postoperative recovery and complications of the two groups were compared,then the two groups were followed-up for 6 months,1 year and 2 years,the recurrence rate of fibroids and menstrual im- provement in the two groups were compared. Results The operative time,postoperative exhaust time,ambulation time, hospitalization time of the two groups were compared, and there was no statistical difference between the two groups （P〉0.05）;while peri-operative bleeding, postoperative complications of the observation group were less than that in the control group （P〈0.05） recurrence rate of fibroids in the observation group after 6 months,1 year,2 years follow-up were significantly lower than that in the control group （P〈0.05） ;the menstruation improvement afer 6 months,1 year follow-up was better than that in the control group （P〈0.05）,but after 2 years follow-up,the menstruation improrvement of the two groups was compared,and there was no statistical difference between the two groups （P〉0.05）. Conclusion Laparoscopic myomectomy combined with uterine artery blockage has good effect in treatment of uterine fibroids with small damage,quick recovery,less peri-operative bleeding,low rate of complications and disease recurrence,and men- struation improvement is good,so it should be widely applied in clinical practice.