不同手术方式在巨大子宫肌瘤剔除中的应用和选择

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摘要目的探讨不同手术方式在巨大子宫肌瘤剔除中的应用和选择。方法回顾分析本院2010年1月—2013年12月巨大子宫肌瘤在TAM、LM、TVM前是否行UAE的临床资料和认真遴选的相关文献资料进行对比研究。结果 ①LM、TVM前行UAE组术中出血量少于非UAE组,手术时间短于非UAE组,住院时间长于非UAE组,住院费用高于非UAE组,差异均有统计学意义。两组TAM围术期指标比较,差异均无统计学意义。62.5%UAE后出现低热、下腹疼痛或伴阴道排液等不良反应。②文献分析显示,TAM术中使用止血带者术后Hb下降值显著低于未用止血带;LM手术时间明显长于TAM,术后住院时间明显短于TAM;子宫如孕14~20周者LM手术时间长于子宫＜14孕周,术中出血量多于子宫＜14孕周;差异均有统计学意义。结论 UAE后施行TAM、LM、TVM,出血量减少,手术时间缩短,术后月经恢复快,未发生子宫内膜和卵巢损伤。UAE后TVM、LM、LAVM或TAM手术方式的选择应结合肌瘤大小、部位、个数,有无合并症,手术者经验、擅长或偏好的手术方式,患者需求意愿和医院配置等多因素综合分析,尽可能为患者提供最合适微创术式。

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	骆文香
	袁新平
	张鸿慧
	崔向华
	石丽芳
	潘祥梅
	陈金婵
	朱丽娟
	杨秀兰
	刘婕娜

关键词 ：巨大子宫肌瘤, 子宫肌瘤剔除术, 微创, 子宫动脉栓塞, 止血措施

引用本文:

骆文香, 袁新平, 张鸿慧, 崔向华, 石丽芳, 潘祥梅, 陈金婵, 朱丽娟, 杨秀兰, 刘婕娜. 不同手术方式在巨大子宫肌瘤剔除中的应用和选择[J]. 中国生育健康杂志, 2016, 27(1): 59-63.

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http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2016/V27/I1/59

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