新式多发性子宫肌瘤剔除子宫重建术1例(病例报道并文献复习)

A New Method of Multiple Myomectomy and Uterine Reconstruction(Case Report and Literature Re-view)

目的介绍一种新式子宫肌瘤剔除术并行子宫重建的操作方法,并观察其疗效。方法对1例要求保留生育功能的多发性子宫肌瘤患者采取了该手术方法。术中探查盆腔及子宫后,子宫肌内注射垂体后叶素6 U(30 mL),将止血带穿过双侧阔韧带无血管区环绕宫颈,暂时阻断双侧子宫动脉血供,切开子宫后壁肌层剥离瘤体,瘤体剔除干净后行子宫重建(“三瓣法”缝合)。结果患者手术过程顺利,如期出院。术后1个月随访阴道彩超提示子宫肌层分布不均,未见其他异常,现仍在随访中。结论子宫肌瘤剔除+“三瓣法”缝合子宫重建,是有生育要求的多发性子宫肌瘤患者的可选方法之一。

Objective To introduce the operation method of new uterine reconstruction("triple flaps")suture for myomectomy and explore its curative effect.Methods This method was applied to a patient with multiple uterine leiomyoma who required to preserve fertility function.After the pelvic cavity and uterus were explored during the operation,6U(30 mL)Pituitrin was injected intramuscularly.The tourniquet was passed through the avascular area of the bilateral broad ligaments to encircle the cervix,temporarily blocking the blood supply of the bilateral uterine arteries.The myometrium of the posterior wall of the uterus was cut off to strip the hysteromyoma.After all of the hysteromyoma was removed,the uterus was sutured by"triple flaps"method.Results The patient had a smooth operation and was discharged as scheduled.After 3 months of follow-up,vaginal color Doppler ultrasound showed that the myometrium was unevenly distributed,and no other abnormalities were found.She was still in follow-up.Conclusion The"triple flaps"suture for myomectomy is one of the choices for multiple myomectomy patients with reproductive requirements.