姚文超 彭繼紅

摘? ?要：目的? 探討腹腔鏡下電凝阻斷子宮動(dòng)脈在子宮肌瘤剔除術(shù)中的應(yīng)用及預(yù)后。方法? 對(duì)2009年2月～2011年2月來我院因子宮肌瘤行肌瘤剝除手術(shù)治療的住院患者共83例，按照隨機(jī)數(shù)字表法將患者分為實(shí)驗(yàn)組和對(duì)照組，實(shí)驗(yàn)組41例先行腹腔鏡下子宮動(dòng)脈電凝阻斷再行肌瘤剝除術(shù)，對(duì)照組42例直接行腹腔鏡下子宮肌瘤剝除術(shù)，比較兩組的手術(shù)時(shí)間、術(shù)中出血量、肛門排氣時(shí)間、住院時(shí)間、并發(fā)癥發(fā)生率。2年內(nèi)對(duì)所有患者定期隨訪，觀察月經(jīng)量，B超復(fù)查監(jiān)測肌瘤復(fù)發(fā)情況。結(jié)果? 與對(duì)照組比較，實(shí)驗(yàn)組手術(shù)時(shí)間縮短（109.92±17.52）min vs（84.83±8.63）min，術(shù)中出血量減少（163.13±36.42）ml vs（94.42±13.73）ml，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;兩組患者的肛門排氣時(shí)間（29.64±2.44）h vs（28.84±2.94）h、住院時(shí)間（6.53±0.63）d vs（6.23±0.92）d、并發(fā)癥發(fā)生率7.10% vs 7.30%比較，差異無統(tǒng)計(jì)學(xué)意義（P>0.05）。隨訪2年，實(shí)驗(yàn)組月經(jīng)量少于對(duì)照組（60.53±17.62）ml vs（133.82±32.53）ml，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。實(shí)驗(yàn)組肌瘤無1例復(fù)發(fā)，對(duì)照組子宮肌瘤有6例復(fù)發(fā)，實(shí)驗(yàn)組復(fù)發(fā)率（0%）優(yōu)于對(duì)照組（14.30%），差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論? 腹腔鏡下電凝阻斷子宮動(dòng)脈后再行肌瘤剝除術(shù)可有效的減少術(shù)中出血量，縮短手術(shù)時(shí)間，減少術(shù)后月經(jīng)量，降低肌瘤復(fù)發(fā)率。

關(guān)鍵詞：腹腔鏡;子宮肌瘤;子宮動(dòng)脈阻斷

中圖分類號(hào)：R737.33? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻(xiàn)標(biāo)識(shí)碼：A? ? ? ? ? ? ? ? ? ? ? ? ? ? ?DOI：10.3969/j.issn.1006-1959.2018.21.028

文章編號(hào)：1006-1959（2018）21-0103-03

Application and Prognosis of Laparoscopic Electrocoagulation for Uterine Artery Removal in Patients with Uterine Fibroids without Fertility Requirements

YAO Wen-chao，PENG Ji-hong

（Department of Obstetrics and Gynecology，Liyang Branch，Jiangsu Hospital of Traditional Chinese Medicine，

Liyang 213300，Jiangsu，China）

Abstract：Objective? To investigate the application and prognosis of laparoscopic electrocoagulation for uterine artery removal in uterine fibroids. Methods? A total of 83 inpatients who underwent fibroidectomy in our hospital from February 2009 to February 2011 were enrolled. The patients were divided into experimental group and control group according to the random number table method.In the experimental group， 41 cases underwent laparoscopic uterine artery electrocoagulation to block the myomectomy， and 42 patients in the control group underwent laparoscopic uterine fibroids removal. The operation time and intraoperative blood loss were compared between the two groups. Anal exhaust time， hospital stay， and complication rate. All patients were followed up regularly within 2 years to observe the menstrual volume， and B-ultrasound was used to monitor the recurrence of fibroids. Results? Compared with the control group， the operation time of the experimental group was shortened （109.92±17.52） min vs （84.83±8.63） min， and the intraoperative blood loss was reduced （163.13±36.42） ml vs （94.42±13.73） ml，the difference was statistically significant （P<0.05）;The anus exhaust time （29.64±2.44） h vs （28.84±2.94） h， hospitalization time （6.53±0.63） d vs （6.23±0.92） d， and the complication rate of 7.10% vs 7.30% in the two groups were compared，the difference was not statistically significant （P>0.05）. After two years of regular follow-up， the menstrual volume of the experimental group was less than that of the control group （60.53±17.62） ml vs （133.82±32.53） ml，the difference was statistically significant （P<0.05）. There was no recurrence of fibroids in the experimental group， and 6 cases of uterine fibroids in the control group recurred. The recurrence rate of the experimental group （0%） was better than that of the control group （14.30%），the difference was statistically significant （P<0.05）. Conclusion? Laparoscopic electrocoagulation to block the uterine artery and then undergoing myomectomy can effectively reduce the intraoperative blood loss， shorten the operation time， reduce the postoperative menstrual flow and reduce the recurrence rate of fibroids.