腹腔镜下子宫动脉阻断术辅助子宫肌瘤剔除术对生育功能的影响

Effects of Myomectomy Assisted by Laparoscopic Uterine Arterial Blocking Technique on Fertility and Relapse Related Risk Factors

目的探讨腹腔镜下子宫动脉阻断术辅助子宫肌瘤剔除术对子宫肌瘤患者术后生育功能的影响,并分析复发相关危险因素.方法选取子宫肌瘤患者162例,接受腹腔镜下子宫动脉阻断术辅助子宫肌瘤剔除术者70例为观察组,接受腹腔镜子宫肌瘤剔除术者92例为对照组.对两组患者术后妊娠及复发情况进行比较,并对复发的相关因素进行统计学分析.结果对照组术后妊娠率为83.7%(77/92),复发率为17.4%(16/92);观察组术后妊娠率为84.3%(59/70),复发率为15.7%(11/70).两组患者术后妊娠及复发率比较差异无统计学意义(χ2=0.010 3,0.080 5,P=0.919 3,0.776 6).年龄、体质量指数(BMI)、术前产次、肌瘤数目、肌瘤大小以及肌瘤分型是影响术后复发的相关危险因素(P<0.05),而年龄、BMI、肌瘤数目以及术前产次是影响术后复发的独立危险因素(P<0.05).结论腹腔镜下子宫动脉阻断术辅助子宫肌瘤剔除术对子宫肌瘤患者术后妊娠率无明显影响,但不能显著改善术后复发率.

Objective To explore the effects of myomectomy assisted by laparoscopic uterine arterial blocking technique on fertility in patients with uterine fibroids,and to analyze the risk factors affecting relapse.Method A total of 162 uterine fibroids patients were enrolled and divided into observation group and control group according to the operative modes. The observation group（ 70 cases） received transient uterine arterial ligation before uterine myomectomy,while the control group（ 92 cases） received laparoscopic myomectomy without uterine artery ligation. The pregnancy and relapse between the two groups were compared. And the related factors which could affect relapse were also analyzed statistically. Results The pregnancy and recurrence rates were 83. 7%（ 77/92） and 17. 4%（ 16/92） in the control group,and 84. 3%（ 59/70） and 15. 7%（ 11/70） in the observation group,respectively. There was no significant difference between the two groups（ χ2= 0. 010 3,0. 080 5,P = 0. 919 3,0. 776 6）. Univariate analysis identified that age,preoperative delivery,and number,size and type of myomas were related factors for relapse,while age,BMI,preoperative delivery and the number of myomas were independent risk factors for relapse. Conclusion Laparoscopic uterine arterial blocking assisted myomectomy has not obvious impact on the pregnancy rate of uterine fibroids patients,but could not significantly improve postoperative relapse rate.