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目的:探讨腹腔镜下子宫肌瘤切除联合子宫动脉阻断术治疗子宫肌瘤的安全性和有效性。方法:将行腹腔镜下子宫肌瘤切除术的子宫肌瘤患者80例分为联合子宫动脉阻断术组(阻断组)和不联合子宫动脉阻断术组(对照组),比较2组患者的术中情况及术后恢复情况。结果:所有患者均痊愈出院,无中转开腹手术患者。阻断组患者手术时间、术中失血量、首次肠胃排气时间、术后住院时间和术后疼痛评分均明显少于或优于对照组(P<0.01)。2组患者术前白细胞介素(IL-1)、IL-6和肿瘤坏死因子-α(TNF-α)水平差异均无统计学意义(P>0.05)。阻断组术后3 d血清IL-1、IL-6和TNF-α水平均显著低于对照组(P<0.01)。2组患者随访过程中,阻断组患者术后月经过多缓解率高于对照组(P<0.05),而月经量和肌瘤复发率均低于对照组(P<0.01和P<0.05)。结论:接受腹腔镜下子宫动脉阻断的患者,手术耐受性好,出血少,术后炎性指标明显较低,随访远期疗效复发率较低,具有临床推广应用价值。
Objective: To investigate the safety and effectiveness of laparoscopic myomectomy combined with uterine artery occlusion in the treatment of uterine fibroids. Methods: 80 cases of uterine leiomyoma who underwent laparoscopic myomectomy were divided into two groups: the combined uterine arterial occlusion group (blocking group) and the non-uterine artery occlusion group (control group) The patient’s intraoperative situation and postoperative recovery. Results: All patients were cured and discharged without conversion to open surgery. The operation time, intraoperative blood loss, first gastrointestinal bleeding time, postoperative hospital stay and postoperative pain scores in the blocking group were significantly less than or better than those in the control group (P <0.01). The levels of IL-1, IL-6 and tumor necrosis factor-α (TNF-α) in the two groups had no significant difference before operation (P> 0.05). Serum levels of IL-1, IL-6 and TNF-α in the obstruction group were significantly lower than those in the control group on the 3rd postoperative day (P <0.01). During the follow-up of the two groups, the rate of postoperative menorrhagia in the obstruction group was significantly higher than that in the control group (P <0.05), but the menstrual flow rate and fibroid recurrence rate were lower than those in the control group (P <0.01 and P <0.05) . Conclusion: Patients undergoing laparoscopic uterine arterial occlusion have good surgical tolerance, less bleeding, and significantly lower postoperative inflammatory markers. The follow-up long-term follow-up has a low recurrence rate and is of clinical value in clinical application.