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目的通过对比研究,探讨止血带阻断子宫动脉上行支在腹腔镜子宫肌瘤剔除术(Laparoscopic myomectomy,LM)中的临床效果和价值。方法选取该院2011年1月-2014年8月诊治的84例子宫肌壁间肌瘤病患为研究对象,设行LM前先行腹腔镜下止血带阻断子宫动脉上行支的42例为研究组,设直接行LM 42例为对照组,将两组手术时间、术中出血量、排气时间、子宫肌瘤复发及月经情况进行比较。结果所有病患手术均成功,研究组术中出血量(83.12±8.25)ml,明显少于对照组的(126.62±15.11)ml,研究组手术时间(67.52±7.45)min短于对照组的(90.25±15.64)min,差异均有统计学意义(P<0.05);研究组术后子宫肌瘤复发率(7.14%)低于对照组(21.42%),差异有统计学意义(P<0.05),研究组术后首次月经来潮时间(36.44±3.30)d,晚于对照组的(31.12±2.05)d,差异有统计学意义(P<0.05)。结论腹腔镜下止血带应用辅助子宫肌瘤剔除术可减少出血量,具有缩短手术时间,降低复发率低等优点,值得临床推广。
Objective To compare the clinical efficacy and value of tourniquet block in blocking the upward branch of uterine artery in laparoscopic Laparoscopic myomectomy (LM). Methods A total of 84 patients with uterine muscular intramural fibroids treated in our hospital from January 2011 to August 2014 were enrolled in this study. 42 cases of uterine artery ascending branch were treated with laparoscopic tourniquet before LM Group, set directly to the LM 42 cases as control group, the two groups operation time, blood loss, exhaust time, recurrence of uterine fibroids and menstrual conditions were compared. Results All the patients were operated successfully. The blood loss in the study group was 83.12 ± 8.25 ml, which was significantly lower than that in the control group (126.62 ± 15.11) ml. The operation time in the study group (67.52 ± 7.45) min was shorter than that in the control group 90.25 ± 15.64) min, the differences were statistically significant (P <0.05). The recurrence rate of uterine fibroids in study group was lower than that in control group (7.14% vs 21.42%, P <0.05) (36.44 ± 3.30) d after the first postoperatively, and later than the control group (31.12 ± 2.05) d, the difference was statistically significant (P <0.05). Conclusion Laparoscopic tourniquet-assisted myomectomy can reduce the amount of bleeding, shorten the operation time and reduce the recurrence rate, which is worthy of clinical promotion.