妇产科子宫肌瘤腹腔镜剔除术临床分析

Clinical Observation of Laparoscopic Removal of Uterine Fibroids in Obstetrics and Gynecology

目的对子宫肌瘤剔除术(腹腔镜下)的子宫肌瘤治疗效果情况加以分析。方法选择2014年8月—2015年8月这一时间段中的要求保留子宫的子宫肌瘤患者共计48例开展子宫肌瘤剔除术(腹腔镜下)作为"研究组",其中子宫动脉阻断术(腹腔镜下)配合治疗者共计18例,同等数量开展开腹手术的患者作为"对照组"。其中研究组病例应具备如下入选条件:1≥5 cm的子宫肌瘤(症状性)径线;2不多于7个的肌瘤数目(B超检查);3主要临床症状被定位为压迫症状、盆腔包块等盆腔占位症状及月经过多等;4所有病患在术前都对血清CA199、CA125、CEA、AFP之类加以检测。结果 48例手术均获得相应的成功,未发生中转开腹、血管撕裂以及各种出血(难以控制)、邻近脏器(输尿管、膀胱之类)损伤等状况。研究组有着分别为(87.52±18.35)mL和(105.6±27.6)min的术中出血和用时平均数。术前B超提示情况和术中剥离肌瘤枚数、大小之类都基本符合,其差异无统计学意义。结论按照相应类型的病例特点以及相应要求,借助于子宫动脉阻断术、子宫肌瘤剔除术(腹腔镜下)对子宫肌瘤的治疗都能够得到令人满意的临床效果。子宫肌瘤剔除术(腹腔镜下)和子宫动脉阻断术相互结合的做法,能够很大程度上降低术后复发率、缩短手术时间、减少术中出血量,由于创面电凝少且术野清晰,使得术后并发症获得了有效的减少。

Objective To analyze the curative effect of the treatment of uterine myoma by uterine myoma. Methods August 2014 to August 2015 this time period in preserving uterine leiomyoma patients a total of 48 cases of myomectomy（laparoscopic） as a ＂study group＂, which uterine artery blocking operation（laparoscopic） with the treatment, a total of 18 cases and an equal number of open abdominal surgery patients as the control group. The study group should have the following conditions： 1 was more than 5cm of uterine fibroids（symptomatic） diameter. No more than 7 of the number of fibroids（B ultrasound）. The main clinical symptoms were localized to the symptoms of compression, pelvic mass and other symptoms of pelvic space, such as excessive menstruation, etc.. All patients in the preoperative serum CA199,CA125, CEA, AFP, to detect. Results 48 cases of surgery were successful, no conversion to open surgery, vascular tear and a variety of bleeding（difficult to control）, adjacent organs（ureter, bladder and the like） damage, etc. The study group had a mean of（87.52±18.35） mL and（105.6±27.6） min. Preoperative B ultrasound and the number, size and the like are basically in line with the number of cases, the difference was not statistically significant. Conclusion According to the corresponding characteristics of the cases and the corresponding requirements, with the aid of in uterine artery blocking operation, myomectomy（laparoscopic） for uterine fibroids treatment can get satisfactory clinical effect.Myomectomy（laparoscopic） and uterine artery occlusion surgery combined with each other, can largely reduce the postoperative recurrence rate, shorten operation time, reduce intraoperative blood loss, due to wound electric coagulation and clear operation field, the postoperative complications for the reduction of the effective.