透明质酸钠预防腹腔镜下子宫肌瘤剔除术后粘连的疗效

Effects of sodium hyaluronate on preventing adhesion after laparoscopic myomectomy

目的 探讨透明质酸钠（ HA）在预防腹腔镜下子宫肌瘤剔除术后粘连中的治疗效果。方法 选取苏州市立医院北区妇产科2011年9月至2013年8月行腹腔镜下子宫肌瘤剔除术的患者120例，将其随机分为HA组（60例）和对照组（60例），观察组在手术过程中给与HA进行术后粘连的预防。结果 观察组患者的轻度粘连发生率、重度粘连发生率、非致密粘连发生率、致密粘连发生率均显著低于对照组患者（χ^2分别为6．124、5．115、9．235、8．147，均P＜0．05）。观察组患者术后的血清白介素（IL）-6、IL-10、肿瘤坏死因子（TNF）-α、C－反应蛋白（CRP）水平均显著低于对照组（t值分别为166．32、70．16、51．14、49．08，均P＜0．05）。观察组术后感染、子宫穿孔、皮下积液并发症发生率均显著低于对照组（χ^2分别为5．124、4．128、6．237，均P＜0．05），观察组术后总并发症显著低于对照组（χ^2=9．237，P＜0．05）。结论 腹腔镜下子宫肌瘤剔除手术中使用HA可以有效预防术后粘连的发生。

Objective To explore the effect of hyaluronic acid （ HA ） on the prevention of adhesion after laparoscopic myomectomy . Methods From September 2011 to August 2013 120 patients with laparoscopic myomectomy in Suzhou Municipal Hospital of Jiangsu Province were selected and randomly divided into HA group （60 cases） and control group （60 cases）.The HA group was given HA in the operation to prevent postoperative adhesion .Results The incidence of mild adhesion , severe adhesion , non-dense adhesion and dense adhesion in the HA group was significantly lower than that in the control group （χ^2value was 6.124, 5.115, 9.235 and 8.147, respectively, all P〈0.05）.The levels of serum IL-6, IL-10, TNF-αand CRP in the HA group were significantly lower than those in the control group （t value was 166.32, 70.16, 51.14 and 49.08, respectively, all P 〈0.05）.The incidence rates of infection, uterus perforation and subcutaneous fluidify in the HA group were significantly lower than that in the control group （χ^2value was 5.124, 4.128 and 6.237, respectively, all P〈0.05）.The total postoperative complications in the HA group was significantly lower than that in the control group （χ^2=9.237,P〈0.05）.Conclusion Postoperative adhesion can be effectively prevented in laparoscopic uterine myomectomy by using HA in operation .