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目的探讨腹腔镜下子宫肌瘤挖除术中减少出血的方法。方法筛选2005年8月至2007年9月期间我科收治的98例子宫肌瘤患者(除外浆膜下子宫肌瘤、黏膜下肌瘤及未生育者),肌瘤直径大小约为7.1(4～12)cm,其中肌瘤直径<5cm30例,≥5cm68例,单发肌瘤43例,多发55例,行腹腔镜子宫肌瘤挖除术。根据手术方法不同,分为2组,其中直接行子宫肌瘤剔除术的46例(A组),行双侧子宫动脉阻断52例(B组)。结果所有病例均在镜下完成,无1例中转开腹。2组术后肛门恢复排气时间、术后住院时间、术后并发症发生率差异均无显著性(P>0.05)。术中出血量A组(72.6±13.1)ml,B组(32.3±10.3)ml),差异有统计学意义(P<0.05),术后子宫血流恢复良好。结论腹腔镜下子宫肌瘤剔除术中,行双侧子宫动脉阻断术,可明显减少术中出血,值得推广。
Objective To investigate the method of reducing bleeding during laparoscopic myomectomy. Methods A total of 98 patients with uterine fibroids (except subserosal uterine fibroids, submucosal fibroids and non-fertile patients) were screened from August 2005 to September 2007 in our department. The diameter of fibroids was about 7.1 (4 ~ 12) cm, which fibroids diameter <5cm30 cases, ≥5cm68 cases, 43 cases of single myoma, multiple in 55 cases, laparoscopic myomectomy. According to the different surgical methods, divided into two groups, including direct myomectomy in 46 cases (group A), bilateral uterine artery occlusion in 52 cases (group B). Results All the cases were completed under the microscope. None of the cases were converted to open surgery. There was no significant difference in postoperative anus recovery exhaust time, postoperative hospital stay and postoperative complications between the two groups (P> 0.05). Intraoperative blood loss in group A (72.6 ± 13.1) ml, group B (32.3 ± 10.3) ml, the difference was statistically significant (P <0.05), after uterine blood flow recovered well. Conclusion Laparoscopic myomectomy, bilateral uterine artery occlusion, can significantly reduce intraoperative bleeding, it is worth promoting.