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目的:探讨子宫肌瘤剥除(LM)术中先行子宫动脉阻断对患者的生育功能及肌瘤复发的影响。方法:将2009年11月～2010年10月行LM时先行子宫动脉阻断的子宫肌瘤患者40例为实验组,以2008年12月～2009年10月直接行LM的子宫肌瘤患者36例为对照组,比较两组患者的手术时间、术中出血量、随访期月经症状、子宫大小、雌二醇水平及肿瘤复发情况。结果:实验组的手术时间、术中出血量分别为(89.4±22.5)min、(86.0±12.7)ml,对照组的手术时间、术中出血量分别为(107.6±38.9)min、(195.3±25.5)ml,两组比较差异有统计学意义(P<0.05);两组患者排卵期及黄体期的雌二醇水平均在正常值范围内;实验组的月经症状缓解率为95.0%,明显高于对照组的80.6%(P<0.01);子宫肌瘤复发率为2.5%,明显低于对照组的13.9%(P<0.01)。结论:LM术中先行子宫动脉阻断可减少术中出血量,降低手术时间,不影响子宫的生育功能,术后肌瘤复发率低。
Objective: To investigate the effect of uterine fibroids stripping (LM) on the reproductive function and recurrence of myoma in patients with uterine artery occlusion. Methods: From November 2009 to October 2010, 40 cases of uterine leiomyoma who underwent uterine artery occlusion by LM were selected as experimental group. Patients with uterine fibroids who underwent LM directly from December 2008 to October 2009 In the control group, the operation time, intraoperative blood loss, menstrual symptoms at follow-up, uterine size, estradiol level and tumor recurrence were compared between the two groups. Results The operation time and intraoperative blood loss in the experimental group were (89.4 ± 22.5) min and (86.0 ± 12.7) ml, respectively. The operation time and blood loss in the control group were (107.6 ± 38.9) min and (195.3 ± 25.5) ml, the difference between the two groups was statistically significant (P <0.05). The ovulation and luteal estradiol levels in both groups were within the normal range. The remission rate of menstruation in the experimental group was 95.0% (80.6%) of the control group (P <0.01). The recurrence rate of uterine myoma was 2.5%, which was significantly lower than that of the control group (13.9%, P <0.01). Conclusion: The first intrauterine uterine artery occlusion can reduce the intraoperative blood loss, reduce the operation time, does not affect the reproductive function of the uterus, postoperative recurrence rate of fibroids is low.