腹腔镜下子宫动脉阻断术加病灶旋切术治疗子宫腺肌病.doc

腹腔镜下子宫动脉阻断术加病灶旋切术治疗子宫腺肌病 医学临床研究2007午筮鲞箜塑!!!!:!!!!?1923? ? 论着? 腹腔镜下子宫动脉阻断术加病灶旋切术治疗子宫腺肌病 付敏彭凤云李桂林徐丛剑 (1.徐州市妇幼保健院,江苏徐州221009;2.复旦大学附属妇产科医院,上海200011) [摘ig]I目的】探讨腹腔镜下子宫动脉阻断术加病灶旋切术治疗子宫腺肌病的临床疗效.【方法】对30 例局限型子宫腺肌病患者行腹腔镜下子宫动脉阻断术加病灶旋切术治疗,残留病灶采用单极法电消融术. 对合并子宫肌瘤或卵巢巧克力囊肿同时行子宫肌瘤挖除术或卵巢巧克力囊肿剥除术.合并有盆腔子宫内膜 异位症,盆腔粘连者行粘连分离及盆腔子宫内膜异位灶电灼术.术后观察月经量,痛经程度,子宫体积等变 化.【结果】术后月经量减至术前的(49±19),23例(76.7)痛经完全消失,9例(16.6)痛经明显缓解,2 例(6.7)痛经部分缓解.术后疼痛评分,分级均明显降低(Plt;O.01);子宫体积明显缩小.【结论】腹腔镜 下子宫动脉阻断术加病灶旋切术治疗子宫腺肌病是一种安全,有效治疗子宫腺肌病的新方法,近期疗效显 着,患者易于接受. [关键词]子宫疾病/外科学;外科手术,腹腔镜 LaparoscopicUterineArteryblockageandExcisionofLesionfortheTreatmentofAdenomyosis FUMin,PENGFeng—yun,LIGui—Z,etal(XuzhouMateralityamp;ChildHospital,Xuzhou, 221009,Jiangsu) [Abstract]【0bjective】Toassesstheclinicalefficacyoflaparoscopicuterinearteryblockageandexcisionof lesionforthetreatmentofadenomyosis.[Methods]Laparoscopicuterinearteryblockageandexcisionoflesion wereperformedin30patientswithadenomyosis,monopoleelectromyolysiswasperformedinremnantsofle— slon.Myomectomyandenucleationwereperformedatthesametimeinpatientswithuterineleiomyomaand chocolatecystofovary.Lysisofadhesionandvaporizationofendometriosiswereperformedinsomepatients. Symptomsanduterinevolumesofallpatientswereinvestigatedaftertreatment.【Results]Relievedclinical symptomswerefoundinall30patients.Menstrualbloodvolumewasreducedto(49±19).Completedisap— pearanceofdysmenorrheawasfoundin23patients(76.7),significantlyalleviatedin9patients(16.6), partiallyalleviatedin2patients(6.7).Painscoreandclassificationweredecreasedsignificantly(Plt;O.01). Theuterinevolumedecreasedsignificantly.[Conclusion]Laparoscopicuterinearteryblockageandexcisionof lesionareaneffectiveandsafemethodforthetreatmentofadenomyosis. [Keywords~uterinediseases/SU;surgicalprocedures,laparoscopic [中图分类号]R711.74[文献标识码]A[文章编号]1671—7171(2007)ll一1923-03 用本术式.本组成功的12例患者中女性多于男性, 可能与女性骨盆相对宽大,盆底相对松弛有关.本 组病例少,且仅针对中低位早中期直肠癌,随访时间 较短,长期疗效,手术经验和对高位直肠癌乃至乙状 结肠癌的是否适用,外翻过程中对肿块的挤压是否 增加癌细胞肛周转移机会等有待进一步观察总结. [参考文献] currenceandsurvivalafterlaparosc