UAE联合腹腔镜治疗Ⅱ型巨大黏膜下子宫肌瘤的效果及对妊娠结局的影响

The Efficacy of UAE Combined with Laparoscopy in the Treatment of Type II Giant Submucosal Hysteromyoma and Its Effect on Pregnancy Outcome

目的:研究子宫动脉栓塞术(UAE)联合腹腔镜治疗Ⅱ型巨大黏膜下子宫肌瘤的效果及对妊娠结局的影响。方法:选择2016年6月~2017年10月期间在某院接受手术治疗的Ⅱ型巨大黏膜下子宫肌瘤患者进行回顾性分析,根据手术方式不同分为接受UAE联合腹腔镜治疗的观察组与开腹手术治疗的对照组,比较两组患者的手术情况、血清炎症及应激指标、妊娠结局。结果:与对照组比较,观察组患者的手术时间及妊娠率、妊娠时间、妊娠期并发症发生率、新生儿体质量与对照组无明显差异(P>0.05),术中出血量明显减少、术后肛门排气时间明显缩短(P<0.05),手术后的血清C反应蛋白(CRP)、白细胞介素(IL)-1、IL-6、单核细胞趋化蛋白-1(MCP-1)、皮质醇(Cor)、生长激素(GH)、血管紧张素-II(AT-II)、胰岛素(F-INS)含量均明显低于对照组(P<0.05)。结论:UAE联合腹腔镜治疗Ⅱ型巨大黏膜下子宫肌瘤具有创伤小、恢复快且不影响远期妊娠结局的特点。

Objective:To study the efficacy of uterine artery embolization(UAE)combined with laparoscopy in the treatment of type II giant submucosal hysteromyoma and its effect on pregnancy outcome.Methods:The patients with type II giant submucosal hysteromyoma who underwent surgical treatment in a hospital from June 2016 to October 2017 were retrospectively analyzed.According to the different surgical methods,they were divided into observation group receiving UAE combined with laparoscopic treatment and control group receiving open surgery.The operation condition,serum inflammation,stress index and pregnancy outcome were compared between the two groups.Results:Compared with the control group,there was no significant difference in operation time,pregnancy rate,pregnancy time,pregnancy complications rate and neonatal body mass between the observation group and control group(P>0.05),the bleeding volume during operation was significantly reduced,the time of anal exhaust after operation was significantly shortened(P<0.05),and the serum C-reactive protein(CRP),interleukin(IL)-1,IL-6 and monocyte chemoattractant protein 1(MCP-1),cortisol(Cor),growth hormone(GH),angiotensin-II(AT-II),insulin(F-INS)after operation in the observation were significantly lower than those in the control group(P<0.05).Conclusion:UAE combined with laparoscopy in the treatment of type II giant submucosal hysteromyoma has the characteristics of minimal trauma,rapid recovery without affecting long-term pregnancy outcomes.