戴金城

[摘要]目的 探讨腹腔镜下应用子宫动脉阻断联合肌瘤切除术对子宫肌瘤患者卵巢功能及生育功能的影响。方法 将2013年6月～2015年8月于我院确诊为子宫肌瘤并行腹腔镜治疗的82例患者纳入研究并分组，两组均行肌瘤切除术，对照组40例患者在肌瘤切除术前不阻断子宫动脉，观察组42例则在肌瘤切除前阻断子宫动脉，比较两组的手术疗效。结果 与对照组比较，观察组的手术时间、术后排气时间均更短，术中出血量更少（P<0.05）。观察组术后2个月的雌二醇（E2）、卵泡生成激素（FSH）水平低于对照组（P<0.05），但两组患者术后6个月的各指标差异无统计学意义（P>0.05）。观察组术后6个月、1年内的肌瘤复发率低于对照组（P<0.05）；两组患者的术后1年妊娠率差异无统计学意义（P>0.05）。结论 腹腔镜下应用子宫动脉阻断联合肌瘤切除术创伤小，复发率低，且不会影响卵巢及生育功能，值得推广。

[关键词]腹腔镜下子宫动脉阻断；肌瘤切除术；子宫肌瘤；卵巢功能；窦状卵泡

[中图分类号] R711.74 [文献标识码] A [文章编号] 1674-4721（2016）12（b）-0087-04

The influence of uterine artery block combined with myomectomy under laparoscope on the ovarian function and reproductive function of patients with uterine fibroid

DAI Jin-cheng

Maternal and Child Health Hospital·Children′s Hospital·Ophthalmic Hospital of Quanzhou City in Fujian Province，Quanzhou 362000，China

[Abstract]Objective To study the influence of laparoscopic uterine artery block jcombined with myomectomy on the ovarian function and reproductive function of patients with uterine fibroid.Methods 82 patients diagnosed uterine fibroid and given laparoscopic treatment by our hospital from June 2013 to August 2015 were admitted into the study and they were divided into two groups.Two groups were given myomectomy，and the control group was not treated with the uterine artery block，while the observation group accepted the uterine artery block before resecting the fibroid.The curative effect of operation between was compared.Results Compared with the control group，the operation time and postoperative exhaust of the observation group were shorter with less intraoperative blood loss （P<0.05）.The observation group with estradiol （E2），follicle hormone （FSH） level were lower than those of control group （P<0.05），but those of the two groups after 6 months had no difference （P>0.05）.Myoma recurrence rate of after 6 months and 1 year operation in the observation group was lower than that of the control group （P<0.05）.Postoperative pregnancy rate of 1 year between two groups had no significant difference （P>0.05）.Conclusion The trauma of uterine artery block combined with myomectomy under laparoscope is small，the recurrence rate is low and will not affect ovarian and reproductive function，and it is worthy of promotion.

[Key words ]Laparoscopic uterine artery block；Myomectomy；Uterine fibroids；Ovarian function；Shape of sinus follicle

子宮肌瘤多属于良性肿瘤，国内发病率为20%～50%，大多患者预后较好，不会对身体健康及日常工作生活造成影响[1]，但部分患者可因经期血量过多引起贫血，轻者引起头晕不适，重者可影响心肌功能，诱发缺血性心肌病[2]。子宫除了孕育胎儿以外，还有内分泌功能，能产生多种活性物质，手术是本病的主要治疗手段，在绝经前切除子宫，常易引发骨质疏松症、更年期综合征提早出现，因此如何减少手术创伤仍是日后研究的重点[3]。腹腔镜具有创伤小的优势，已被广泛应用于临床，但由于部分较小的肌瘤不易经彩超发现，术中未被切除，从而导致术后仍存在较高的复发率。……