腹腔镜超声辅助在子宫肌瘤患者微创手术中的应用研究

Application of laparoscopic ultrasonography assistance in minimally invasive surgery for patients with uterine fibroids

摘要:

目的 探讨腹腔镜超声在辅助子宫肌瘤剔除术中的应用价值，为临床降低子宫肌瘤术后复发率提 供科学依据。方法 选取2011 年1 月-2014 年6 月在该院住院治疗的子宫肌瘤患者156 例，根据数字表法将 患者分为对照组和观察组，每组78 例，对照组患者给予常规的腹腔镜微创治疗，观察组患者给予腹腔镜超声 辅助微创治疗，比较两组患者一般治疗情况、术后残留和12 个月复发的情况、不同时间点的肌瘤个数和肌瘤 直径，分析子宫肌瘤的数目与残留与复发的关系。结果 两组患者手术时间、术中出血量、住院时间以及肛 门排气时间的差异均无统计学意义；观察组患者术后残留的比例以及12 个月内复发的比例明显低于对照组， 且差异具有统计学意义；观察组术后3、6、9 和12 个月的子宫肌瘤数目低于对照组；两组患者术后3 和6 个月子宫肌瘤最大直径的差异无统计学意义，观察组患者术后9 和12 个月的子宫肌瘤的最大直径明显低于对 照组，且差异具有统计学意义；随着患者子宫肌瘤数目的增多，术后的残余发生率和复发率明显提升，当子宫 肌瘤的数目≥ 10 个，残留率为100.0%，复发率为80.0%。结论 腹腔镜超声辅助微创手术应用于子宫肌瘤患者， 可以有效降低术后的残余率和复发率，值得临床推广。

Abstract:

Objective To investigate the effect of laparoscopic ultrasonography assistance in minimally invasive surgery for uterine leiomyoma patients and provide scientific basis for reducing the recurrence rate of uterine leiomyoma. Methods 156 cases of uterine leiomyoma from January 2011 to June 2014 were divided into control group and observation group according to the digital table method, 78 cases in each. The control group were treated with conventional laparoscopic surgery, while the observation group with laparoscopic ultrasonography assistance, then compare the postoperative residue, recurrence in 12 months at different time points and the number of fibroids diameter, analyze the relationship between number of uterine muscle tumor and residual recurrence. Results There were no significant differences in operation time, blood loss, length of hospital stay and anal exhaust time between the two groups. The proportion of patients in the observation group and the recurrence rate within 12 months were significantly lower than those in the control group, the number of uterine leiomyomas in the observation group wassignificantly lower than that in the control group at 3 months, 6 months, 9 months and 12 months after operation. The patients in the two groups were followed up for 3 months and 6 months the maximum diameter of uterine leiomyoma was not statistically significant, the observation group 9 months and 12 months after the maximum diameter of uterine fibroids was significantly lower than the control group, and the difference was statistically significant; with the patient’s uterine muscle the number of residual tumor and the recurrence rate were significantly increased. When the number of uterine leiomyomas was 10 or more, the residual rate was 100.0% and the recurrence rate was 80.0%. Conclusion Laparoscopic ultrasonography assistance in minimally invasive surgery for patients with uterine fibroids can effectively reduce the postoperative residual rate and recurrence rate, worthy of clinical promotion.