经阴道超声定位引导下腹腔镜剔除术治疗多发性子宫肌瘤的疗效及安全性

Efficacy and safety of transvaginal ultrasound positioning-guided laparoscopic myomectomy for multiple uterine myoma

目的 探讨经阴道超声定位引导下腹腔镜剔除术治疗多发性子宫肌瘤的疗效及安全性。方法 选取100例多发性子宫肌瘤患者为研究对象,按照随机数字表法将其分为常规组(n=43)和研究组(n=57),常规组患者采用腹腔镜剔除术治疗,研究组患者采用经阴道超声定位引导下腹腔镜剔除术治疗。比较两组患者围术期相关指标(手术时间、术中出血量、术后排气时间、住院时间)、术前和术后1个月性激素水平[黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E_(2))]、术后1周内并发症(淤血、切口感染、尿频)发生率、术后1个月子宫肌瘤残留率、术后6个月子宫肌瘤复发率。结果 研究组患者手术时间长于常规组(P<0.05),两组患者术中出血量、术后排气时间、住院时间差异均无统计学意义(均P>0.05)。术前及术后1个月,两组患者的LH、FSH、E_(2)水平差异均无统计学意义(均P>0.05);术后1个月,两组患者的LH、FSH水平均较术前升高,E_(2)水平均较术前降低(均P<0.05)。术后1周内两组患者淤血、切口感染、尿频发生率差异均无统计学意义(均P>0.05)。术后1个月,研究组子宫肌瘤残留率低于常规组(P<0.05)。术后6个月内,研究组子宫肌瘤复发率低于常规组(P<0.05)。结论 采用经阴道超声定位引导下腹腔镜剔除术治疗多发性子宫肌瘤所需的手术时间较长,但术后肌瘤残留率和复发率较低,不增加术中出血量、术后排气时间、住院时间和并发症发生率,对性激素水平的影响与常规腹腔镜剔除术相近,疗效好且安全性高,值得在临床上推广应用。

Objective To investigate the efficacy and safety of transvaginal ultrasound positioning-guided laparoscopic myomectomy in the treatment of multiple uterine myoma.Methods A total of 100 patients with multiple uterine myoma were selected as research objects,and they were divided into conventional group(n=43) and research group(n=57) according to the random number table method.Patients in the conventional group were treated with laparoscopic myomectomy,while patients in the research group were treated with transvaginal ultrasound positioning-guided laparoscopic myomectomy.The perioperative-related indexes(operation time,intraoperative blood loss,postoperative exhaust time,hospital stay),sex hormones levels before and 1 month after operation [luteinizing hormone(LH),follicle stimulating hormone(FSH),estradiol(E_(2))],the incidence of postoperative complications(congestion,incision infection,frequent urination) within 1 week after operation,the residual rate of uterine myoma 1 month after operation,and the relapse rate of uterine myoma 6 months after operation were compared between the two groups.Results The operation time of the resreach group was longer than that of the conventional group(P0.05).Before and 1 month after operation,there was no statistically significant difference in LH,FSH,and E_(2) levels between the two groups(all P>0.05).At 1 month after operation,the levels of LH and FSH in the two groups were higher than those before operation,whereas the levels of E_(2) were lower than those before operation(all P0.05).One month after operation,the residual rate of uterine myoma in the research group was lower than that in the conventional group(P<0.05).Within 6 months after operation,the relapse rate of uterine myoma in the research group was lower than that in the conventional group(P<0.05).Conclusion In the treatment of multiple uterine myoma,the transvaginal ultrasound positioning-guided laparoscopic myomectomy requires a longer operation time,but it yields lower postoperative residual rate and relapse rate of uterine myoma.Without increasing the intraoperative blood loss,postoperative exhaust time,hospital stay,and incidence of complications,it has a similar effect to conventional laparoscopic myomectomy,with good efficacy and high safety,and it is worthy of clinical promotion and application.