动态超声监测在多发性子宫肌瘤腹腔镜剔除术中的应用效果

Application of dynamic ultrasound monitoring in laparoscopic resection of multiple uterine myoma

目的探索动态超声监测在腹腔镜多发性子宫肌瘤剔除手术中的应用效果。方法选取2016年10月至2018年6月于中国人民武装警察部队浙江省总队医院接受治疗的56例多发性子宫肌瘤患者为研究对象,按照随机数字表法将患者平均分为两组,观察组患者28例应用动态超声定位辅助腹腔镜进行多发性子宫肌瘤剔除,28例对照组患者应用腹腔镜下多发性子宫肌瘤剔除。观察并比较两组患者的手术情况、肌瘤复发情况及不良反应发生情况。结果两组患者的术中出血量和排气时间比较无显著差异(t值分别为0.876、0.735,均P>0.05),观察组患者的手术时间显著长于对照组(t=2.236,P<0.05),下床活动时间显著短于对照组(t=2.054,P<0.05)。观察组患者的肌瘤残留率、复发率均显著低于对照组(χ~2值分别为4.659、4.876,均P<0.05),且残留肌瘤平均直径显著小于对照组(t=2.021,P<0.05)。患者不良反应主要表现为腹痛和发热,观察组总不良反应发生率显著低于对照组(χ~2=4.351,P<0.05)。结论动态超声辅助行腹腔镜剔除术能够显著降低多发性子宫瘤残留率,完整剔除体积小、深层次的肌瘤,有利于促进患者康复,同时显著降低了复发率和不良反应发生率。

Objective To explore the application of dynamic ultrasound in laparoscopic resection of multiple uterine myoma.Methods Fifty-six patients with multiple uterine myoma treated in Zhejiang Provincial General Hospital of the Chinese People’s Armed Police Force from October 2016 to June 2018 were enrolled.The patients were equally divided into two groups according to random number table method.Twenty-eight patients in the observation group were subjected to dynamic ultrasound localization assisting laparoscopic removal of multiple uterine myoma,and the other 28 patients in the control group underwent laparoscopic resection of multiple uterine myoma.The operation situation,recurrence of fibroids and the occurrence of adverse reactions were observed and compared between two groups.Results There were no significant differences in intraoperative blood loss and exhaust time between two groups ( t value was 0.876 and 0.735,respectively,both P >0.05).The operation time of the observation group was significantly longer than that of the control group ( t =2.236, P <0.05),and the time of getting out of bed was significantly earlier than that of the control group ( t =2.054, P <0.05).The residual rate and recurrence rate of fibroids in the observation group were significantly lower than those in the control group (χ^2 value was 4.659 and 4.876,respectively,both P <0.05),and the mean diameter of residual fibroids was significantly lower than that in the control group ( t =2.021, P <0.05).Adverse reactions of the patients were mainly manifested as abdominal pain and fever,and the total incidence of adverse reactions in the observation group was significantly lower than that in the control group (χ^2=4.351, P <0.05).Conclusion Laparoscopic resection assisted by dynamic ultrasound can significantly reduce the residual rate of multiple uterine tumor,and completely remove small and deep myoma,which is conducive to the recovery of patients and significantly reduces the recurrence rate and the incidence of adverse reactions.