本文關(guān)鍵詞： 腹腔鏡 子宮動脈阻斷 子宮肌瘤 子宮肌瘤剔除　出處：《蘇州大學》2014年碩士論文　論文類型：學位論文

【摘要】：目的：分析腹腔鏡下子宮動脈阻斷后行子宮肌瘤剔除術(shù)與腹腔鏡下子宮肌瘤剔除術(shù)在臨床的治療效果,探討預先阻斷子宮動脈在腹腔鏡下子宮肌瘤剔除術(shù)中的臨床應(yīng)用價值。 方法：選取蘇州大學附屬第二醫(yī)院和蘇州市中西醫(yī)結(jié)合醫(yī)院兩所醫(yī)院同期收治的子宮肌瘤患者103例,均要求保留子宮而行子宮肌瘤剔除,隨機分成2組,研究組63例(多發(fā)性子宮肌瘤34例,單發(fā)性子宮肌瘤29例),腹腔鏡下預先處理子宮動脈,后行子宮肌瘤剔除(LUAO-M)。在腹腔鏡下分離解剖子宮動脈主干,閉合子宮動脈,然后單極電凝鉤切開肌瘤表面包膜,剝離、剔除肌瘤,連續(xù)縫合子宮表面漿肌層切口；對照組40例(多發(fā)性子宮肌瘤21例,單發(fā)性子宮肌瘤19例)。按常規(guī)在腹腔鏡下子宮肌瘤剔除(LM)。比較兩組在手術(shù)時間、術(shù)中出血量、住院日等方面的差異。 結(jié)果：腹腔鏡下子宮動脈阻斷后行子宮肌瘤剔除術(shù),雖手術(shù)時間略長,但術(shù)中出血量少于腹腔鏡下單純肌瘤剔除,尤其是在多發(fā)性子宮肌瘤手術(shù)中。在子宮肌瘤直徑大于7cm的肌瘤腹腔鏡剔除術(shù)中,多發(fā)性子宮肌瘤手術(shù)時間長,但出血少；單發(fā)肌瘤手術(shù)時間兩組無差異,子宮動脈阻斷組術(shù)中出血少。子宮動脈阻斷組術(shù)后月經(jīng)量減少,癥狀改善,肌瘤復發(fā)率低。兩組在術(shù)后平均住院天數(shù)、術(shù)后病率、排氣時間等無統(tǒng)計學差異。 結(jié)論： 1、腹腔鏡下子宮動脈阻斷后行子宮肌瘤剔除可以減少手術(shù)中出血,保留子宮,抑制肌瘤復發(fā)。 2、拓寬腹腔鏡下子宮肌瘤剔除適應(yīng)癥,減少術(shù)后并發(fā)癥,提高手術(shù)質(zhì)量,改善術(shù)后癥狀。 3、雖該手術(shù)方式技術(shù)要求高,但值得推廣。
[Abstract]:Objective: to analyze the clinical effect of uterine myomectomy and laparoscopic hysteromyomectomy after laparoscopic uterine artery occlusion, and to explore the clinical value of pre-blocking uterine artery in laparoscopic hysteromyomectomy. Methods: one hundred and three patients with uterine leiomyoma treated in the second affiliated Hospital of Suzhou University and Suzhou Integrated Chinese and Western Medicine Hospital were randomly divided into two groups. In the study group, 63 cases (34 cases of multiple hysteromyoma and 29 cases of single uterine leiomyoma) were treated with laparoscope to treat the uterine artery, and then the uterine artery was dissected and the uterine artery was closed. Then the monopole hook cut through the surface of the myoma, stripped it, removed it, and sutured the sarcoplasmic myometrium incision on the surface of the uterus, while in the control group, there were 40 cases (21 cases of multiple myoma of the uterus). 19 cases of single uterine leiomyoma were removed by laparoscope. The difference of operation time, intraoperative bleeding volume and hospitalization time were compared between the two groups. Results: hysteromyomectomy was performed under laparoscopic uterine artery occlusion. Although the operative time was a little longer, the amount of intraoperative bleeding was less than that of simple myomectomy under laparoscope. Especially in multiple hysteromyoma surgery, the operation time of multiple hysteromyoma was longer than 7 cm, but the bleeding was less, there was no difference between the two groups in the operation time of single myoma. Uterine artery occlusion group had less bleeding, less menstrual volume, improved symptoms and lower recurrence rate of myoma. There was no significant difference between the two groups in average hospital stay, postoperative disease rate, exhaust time and so on. Conclusion:. 1.Laparoscopic uterine artery occlusion after uterine myomectomy can reduce bleeding, preserve the uterus, and inhibit the recurrence of myoma. 2, broaden the indications of laparoscopic hysteromyoma removal, reduce postoperative complications, improve the quality of surgery and improve postoperative symptoms. 3, although the technical requirements of the operation is high, but it is worth popularizing.
【學位授予單位】：蘇州大學
【學位級別】：碩士
【學位授予年份】：2014
【分類號】：R737.33

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