文晓荣　陈丽春　汤长江

【摘要】 目的：觀察与比较子宫腺肌瘤经腹或腹腔镜剔除术与经皮微波消融治疗的临床效果。方法：选取2020年7月-2021年3月本院收治的60例子宫腺肌瘤患者作为研究对象，将其根据随机数字表法分为对照组（经腹或腹腔镜剔除术）和观察组（经皮微波消融），每组30例。比较两组临床效果、术后疼痛程度（NPRS评分）、伤口恢复情况、手术前后痛经情况（CMSS评分）及血清CA125、并发症发生率。结果：观察组临床总有效率显著高于对照组，术后1、2、3 d的NPRS评分均显著低于对照组，伤口恢复情况显著优于对照组，差异均有统计学意义（P<0.05）。两组术前CMSS评分与血清CA125比较，差异均无统计学意义（P>0.05）;观察组术后1、2、3个月CMSS评分与血清CA125均显著低于对照组，差异均有统计学意义（P<0.05）。两组并发症发生率比较，差异无统计学意义（P>0.05）。结论：经皮微波消融治疗子宫腺肌瘤的临床效果相对较好，且安全性值得肯定，在本类患者中的应用价值相对更高。

【关键词】 子宫腺肌瘤 经腹或腹腔镜剔除术 经皮微波消融术

Study on Comparison of Transabdominal or Laparoscopic Myomectomy and Percutaneous Microwave Ablation for Adenomyoma/WEN Xiaorong， CHEN Lichun， TANG Changjiang. //Medical Innovation of China， 2021， 18（23）： -130

[Abstract] Objective： To observe and compare the clinical effect of transabdominal or laparoscopic myomectomy and percutaneous microwave ablation for adenomyoma. Method： A total of 60 patients with adenomyoma treated in our hospital from July 2020 to March 2021 were chosen as the study objects， and they were divided into the control group （transabdominal or laparoscopic myomectomy） and the observation group （percutaneous microwave ablation）， 30 cases in each group. Then the clinical effect， postoperative pain degree （NPRS score）， wound recovery situation， dysmenorrhea situation and serum CA125 before and after operation， complication rates of two groups were compared. Result： The total effective rate of the observation group was significantly higher than that of the control group， the NPRS score at 1， 2 and 3 d after the operation were significantly lower than those of the control group， the wound recovery situation was significantly better than that of the control group， there were statistically significant differences （P<0.05）. The CMSS score and serum CA125 of two groups before operation compared， there were no statistically significant differences （P>0.05）; the CMSS score and serum CA125 of the observation group at 1， 2 and 3 months after operation were all significantly lower than those of the control group， there were statistically significant differences （P<0.05）. The complication rates of two groups compared， there was no statistically significant difference （P>0.05）. Conclusion： The clinical effect of percutaneous microwave ablation for adenomyoma is better， and its safety is affirmed， so its application value in these patients is relatively higher.

[Key words] Adenomyoma Transabdominal or laparoscopic operation Percutaneous microwave ablation

First-author’s address： The Third People’s Hospital of Longgang District in Shenzhen， Shenzhen 518115， China

doi：10.3969/j.issn.1674-4985.2021.23.031

子宫腺肌瘤在临床多见，对本病的治疗方式研究是临床重点。传统腹腔镜或经腹手术虽对病灶具有较好的切除效果，但其手术创伤较大，术后复发率较高，术后恢复较慢，因此找到疗效更好及安全性较高的治疗方式是临床的研究热点[1-2]。近年来采用经皮微波消融术治疗本类疾病的研究不断增多，且研究多对其效果给予了较高的肯定，但是与此同时，关于其与传统腹腔镜或经腹手术的效果比较差异也极为突出[3-5]，因此两类治疗的细致及全面研究需求较高。……