腹腔镜下子宫肌瘤剔除术与子宫动脉栓塞术治疗子宫肌瘤疗效比较研究
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摘要
目的比较腹腔镜下子宫肌瘤剔除术和子宫动脉栓塞术治疗子宫肌瘤的疗效。方法回顾性分析自2014年1月至2016年6月沈阳市第六人民医院收治的88例子宫肌瘤患者的临床资料,按照术式不同,分为腹腔镜下子宫肌瘤剔除术组(A组,n=42)和子宫动脉栓塞术组(B组,n=46)。比较两组患者围术期不良反应以及随访3、6、12个月的临床症状改善情况、子宫和肌瘤体积变化情况、生存质量情况。结果所有患者围术期均未发生明显不良反应。随访期间,B组月经量增多、痛经症状改善情况明显好于A组,差异有统计学意义(P<0.05),但两组经期延长、贫血、尿路和直肠压迫、盆腔疼痛症状改善情况比较,差异无统计学意义(P>0.05);A组子宫和肌瘤体积缩小比例明显高于B组,差异有统计学意义(P<0.05);B组生存质量改善情况明显好于A组,差异有统计学意义(P<0.05)。结论腹腔镜下子宫肌瘤剔除术和子宫动脉栓塞术治疗子宫肌瘤疗效均良好。
Objective To investigate the clinical efficacy of laparoscopic myomectomy and uterine artery embolization in the treatment of uterine myoma. Methods A retrospective study was performed on 88 cases of patients with uterine myoma who were admitted from January 2014 to June 2016. According to different surgical methods,patients were divided into the laparoscopic myomectomy group(Group A,n = 42)and the uterine artery embolization group(Group B,n = 46). The perioperative adverse reactions,the improvement of clinical symptoms,changes in uterine and fibroid volume,and the life quality of patients during the follow-up period of 3,6 and 12 months were compared between the two groups. Results There were no obvious complications during perioperative period. During the follow-up period,the menstrual volume increased and the dysmenorrhea symptoms improved significantly in Group B which were better than those in Group A( P < 0. 05). There was no statistically significant difference between the two groups of menstrual extension,anemia,urinary tract and rectal compression and pelvic pain symptoms( P > 0. 05). The reduction ratio of uterine and fibroids in Group A was significantly higher than those in Group B( P < 0. 05). The improvement of survival quality in Group B was significantly better than that in Group A,and the difference was statistically significant( P < 0. 05). Conclusion Both laparoscopic myomectomy and uterine artery embolization for uterine fibroids have good therapeutic effect.
Objective To investigate the clinical efficacy of laparoscopic myomectomy and uterine artery embolization in the treatment of uterine myoma. Methods A retrospective study was performed on 88 cases of patients with uterine myoma who were admitted from January 2014 to June 2016. According to different surgical methods,patients were divided into the laparoscopic myomectomy group(Group A,n = 42)and the uterine artery embolization group(Group B,n = 46). The perioperative adverse reactions,the improvement of clinical symptoms,changes in uterine and fibroid volume,and the life quality of patients during the follow-up period of 3,6 and 12 months were compared between the two groups. Results There were no obvious complications during perioperative period. During the follow-up period,the menstrual volume increased and the dysmenorrhea symptoms improved significantly in Group B which were better than those in Group A( P < 0. 05). There was no statistically significant difference between the two groups of menstrual extension,anemia,urinary tract and rectal compression and pelvic pain symptoms( P > 0. 05). The reduction ratio of uterine and fibroids in Group A was significantly higher than those in Group B( P < 0. 05). The improvement of survival quality in Group B was significantly better than that in Group A,and the difference was statistically significant( P < 0. 05). Conclusion Both laparoscopic myomectomy and uterine artery embolization for uterine fibroids have good therapeutic effect.
引文
[1]张瑛瑜,陈芳.腹腔镜下子宫肌瘤剔除术和传统开腹手术的效果比较[J].实用癌症杂志,2016,31(8):1373-1375.
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[7]王明航,李建生,李素云,等.世界卫生组织生存质量测定量表简表用于老年肺炎的信度、效度和反应度[J].中医杂志,2010,51(11):984-986.
[8]杨淑英,向群,陈雪兰,等.腹腔镜子宫肌瘤切除手术难度评分系统在腹腔镜子宫肌瘤切除手术中应用评估[J].中国性科学,2015,24(1):24-26.
[9]Kuzel D,Mara M,Horak P,et al.Comparative outcomes of hysteroscopic examinations performed after uterine artery embolization or laparoscopic uterine artery occlusion to treat leiomyomas[J].Fertility&Sterility,2011,95(6):2143.
[10]赵立红.腹腔镜治疗子宫肌瘤的手术方式与应用效果[J].世界临床医学,2017,11(16):139,141.
[11]布拉盖,王翠如.腹腔镜剔除术治疗子宫肌瘤的临床效果[J].世界临床医学,2017,11(16):122.
[12]朱培欣,李陆鹏,王闯胜.子宫动脉栓塞治疗症状性子宫肌瘤的临床疗效观察[J].当代医学,2017,23(21):90-92.
[13]Mclucas B,Rd VW.Combined myomectomy and uterine artery embolization[J].Minimally Invasive Therapy&Allied Technologies,2014,23(6):361-365.
[14]Nishida M,Ichikawa R,Arai Y,et al.New myomectomy technique for diffuse uterine leiomyomatosis[J].Journal of Obstetrics&Gynaecology Research,2014,40(6):1689-1694.
[15]林坚.经阴道手术与腹腔镜手术治疗子宫肌瘤疗效对比观察[J].中国疗养医学,2017,26(8):844-845.
[16]谭宏伟,胡春艳,李小娟,等.三种不同子宫肌瘤剔除手术临床效果比较[J].陕西医学杂志,2016,45(8):1035-1037.
[2]Zhang Y,Hua KQ.Patients'age,myoma size,myoma location,and interval between myomectomy and pregnancy may influence the pregnancy rate and live birth rate after myomectomy[J].Journal of Laparoendoscopic&Advanced Surgical Techniques,2014,24(2):95-99.
[3]朱定军,叶梅.应用腹腔镜辅助阴式全子宫切除术在巨大子宫肌瘤治疗中的应用价值研究[J].解放军预防医学杂志,2016,34(S2):317-318.
[4]申健.宫腔镜治疗黏膜下子宫肌瘤:260例临床研究[J].临床军医杂志,2016,44(4):351-352.
[5]陈卫东.腹腔镜子宫肌瘤剔除术与开腹手术治疗子宫肌瘤的临床效果比较[J].中国当代医药,2016,23(16):104-106.
[6]娄翠英.腹腔镜和开腹子宫肌瘤剔除术治疗子宫肌瘤效果分析[J].河南外科学杂志,2017,23(5):135-136.
[7]王明航,李建生,李素云,等.世界卫生组织生存质量测定量表简表用于老年肺炎的信度、效度和反应度[J].中医杂志,2010,51(11):984-986.
[8]杨淑英,向群,陈雪兰,等.腹腔镜子宫肌瘤切除手术难度评分系统在腹腔镜子宫肌瘤切除手术中应用评估[J].中国性科学,2015,24(1):24-26.
[9]Kuzel D,Mara M,Horak P,et al.Comparative outcomes of hysteroscopic examinations performed after uterine artery embolization or laparoscopic uterine artery occlusion to treat leiomyomas[J].Fertility&Sterility,2011,95(6):2143.
[10]赵立红.腹腔镜治疗子宫肌瘤的手术方式与应用效果[J].世界临床医学,2017,11(16):139,141.
[11]布拉盖,王翠如.腹腔镜剔除术治疗子宫肌瘤的临床效果[J].世界临床医学,2017,11(16):122.
[12]朱培欣,李陆鹏,王闯胜.子宫动脉栓塞治疗症状性子宫肌瘤的临床疗效观察[J].当代医学,2017,23(21):90-92.
[13]Mclucas B,Rd VW.Combined myomectomy and uterine artery embolization[J].Minimally Invasive Therapy&Allied Technologies,2014,23(6):361-365.
[14]Nishida M,Ichikawa R,Arai Y,et al.New myomectomy technique for diffuse uterine leiomyomatosis[J].Journal of Obstetrics&Gynaecology Research,2014,40(6):1689-1694.
[15]林坚.经阴道手术与腹腔镜手术治疗子宫肌瘤疗效对比观察[J].中国疗养医学,2017,26(8):844-845.
[16]谭宏伟,胡春艳,李小娟,等.三种不同子宫肌瘤剔除手术临床效果比较[J].陕西医学杂志,2016,45(8):1035-1037.