腹腔镜下多种微创保守性术式治疗子宫腺肌病的短期临床疗效分析

Short-term clinical analysis of variety of conservative minimally invasive surgical procedures in the treatment of adenomysis

目的:探讨腹腔镜下多种微创保守性术式治疗子宫腺肌病的短期临床疗效。方法:回顾性分析93例子宫腺肌瘤患者的临床资料,按照不同的手术方式分为三组:A组为子宫动脉阻断术(UAB)组(n=32),B组为病灶切除术组(n=33),C组为子宫动脉阻断联合病灶切除术组(n=28)。比较三组患者手术时间、术中出血量、肛门排气时间、术后疼痛评分、并发症发生率及住院时间、月经量、子宫大小、痛经评分等指标。结果:三组间的手术时间比较,差异有统计学意义(F=2.082,P<0.05);而三组的术中出血量、肛门排气时间、术后疼痛评分、并发症发生率及住院时间比较,差异无统计学意义(P>0.05)。与术前比较,三组患者术后1,3个月的月经量均显著减少,痛经评分下降,子宫体积显著缩小;而术后1,3个月同期多组间各指标比较,差异均无统计学意义(P>0.05)。结论:腹腔镜下子宫动脉阻断术、病灶切除术及子宫动脉阻断联合病灶切除术均可安全用于子宫腺肌病患者,短期随访显示3种术式均可有效改善患者的症状。

Objective：To evaluate the effect of variety of conservative minimally invasive surgical procedures in the treat-ment of adenomysis. Methods：Total 93 adenomsis patients′ clinical data in hospital were elected and studied. According to dif-ferent surgical procedures,patients will be divided into three groups. Group A：uterine uterine artery blockage（UAB）group（n= 32）,group B：lesion resection group（n = 33）,group C：uterine artery blockage combined lesion resection group（n = 28）. To compare three groups of patients′ indicators such as operative time,blood loss,anal exhaust time,postoperative pain scores, complications and length of hospital stay,the amount of menstruation,uterine size,dysmenorrhea scores and other indicators. Results：The operative time between the three groups was statistically significant difference（F = 2. 082,P 0. 05）. Compared with the preoperative,the amount of menstrua-tion,uterine size,dysmenorrhea scores were significantly reduced in all 3 groups in postoperative month 1 and 3,but these indi-cators between difference group in the same time the differences was not statistically significant（P 〉 0. 05）. Conclusion：Lapa-roscopic surgery procedures of uterine artery blockage,lesion resection group,uterine artery blockage combined lesion resection can be safely used in,short - term follow - up shows three kinds of surgical procedures can be effective in improving the symp-toms of adenomyosis patients.