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目的探讨子宫动脉阻断在腹腔镜子宫肌瘤切除术中的应用价值及其对卵巢功能的影响。方法子宫肌瘤患者86例,随机分为两组,对照组行传统的腹腔镜下子宫肌瘤切除术,研究组给予子宫动脉阻断+子宫肌瘤切除治疗,观察两组手术时间、术中出血量、术后排气时间、住院时间、术后发热率及月经改善率,术前及术后1、6个月检测两组卵泡刺激素(FSH)、促黄体生成素(LH)、雌二醇(E2)水平。采用SPSS 17.0统计学软件,计数资料比较采用χ2检验,计量资料比较采用t检验,P<0.05为差异有统计学意义。结果研究组术中出血量少于对照组(P<0.05),两组手术时间、术后排气时间、住院时间差异无统计学意义(P>0.05)。研究组术后发热率(9.3%)低于对照组(18.6%),月经改善率高于对照组(88.4%vs.62.8%),随访1年子宫肌瘤复发率明显低于对照组(2.3%vs.16.2%),组间比较差异均有统计学意义(均P<0.05)。研究组术后1个月FSH水平高于术前,E2水平低于术前,差异有统计学意义(均P<0.05),术后6个月与术前差异无统计学意义(P>0.05)。结论腹腔镜子宫肌瘤切除术中阻断子宫动脉可有效减少术中出血,能有效减少术后复发率、改善月经过多症状,对卵巢功能影响短暂可逆。
Objective To investigate the value of uterine artery block in laparoscopic myomectomy and its effect on ovarian function. Methods Totally 86 patients with uterine fibroids were randomly divided into two groups. The control group underwent conventional laparoscopic myomectomy. The study group was given uterine artery occlusion and myomectomy. The operative time, Bleeding volume, postoperative exhaust time, hospital stay, postoperative fever rate and improvement of menstruation, preoperative and postoperative 1, 6 months were measured FSH, LH, Diol (E2) levels. Using SPSS 17.0 statistical software, count data were compared using χ2 test, measurement data were compared using t test, P <0.05 for the difference was statistically significant. Results The bleeding volume in the study group was less than that in the control group (P <0.05). There was no significant difference in operative time, postoperative exhaust time and hospitalization time between the two groups (P> 0.05). The incidence of postoperative fever in study group (9.3%) was lower than that in control group (18.6%), and the improvement rate of menstruation was higher than that in control group (88.4% vs.62.8%). The recurrence rate of uterine fibroids in follow-up group was significantly lower than that in control group % vs.16.2%), the differences between the groups were statistically significant (all P <0.05). The FSH level in study group was higher than preoperative level at one month and E2 level was lower than preoperative level (all P <0.05), but there was no significant difference at 6 months after operation ). Conclusion Laparoscopic myomectomy block uterine artery can effectively reduce intraoperative bleeding, can effectively reduce the recurrence rate, improve the symptoms of menorrhagia, ovarian function short-term reversible.