腹腔镜下子宫血管阻断术联合子宫肌瘤剜除术治疗子宫肌瘤的回顾性研究.

Objective: To retrospectively analyze the clinical efficacy of laparoscopic uterine vascular occlusion combined with hysteromyoma enucleation in the treatment of hysteromyoma. Methods: The clinical data of patients with hysteromyoma who treated in our hospital from June 2017 to July 2019 were analyzed (n=150). According to different surgical methods, the patients were divided into group A (laparoscopic hysteromyoma enucleation treatment, 73 cases) and group B (laparoscopic uterine vascular occlusion combined with hysteromyoma enucleation treatment, 77 cases). The intraoperative, endocrine hormones, postoperative recovery indexes, pregnancy situation, complication rate and recurrence rate were compared between the two groups. Results: There was no statistical difference in the operative time between the two groups (P>0.05), the intraoperative blood loss in group B was less than that in group A, and the postoperative exhaust time, hospitalization days and out of bed activity time were shorter than those in group A (P<0.05). There were no significant differences in the levels of luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2) in group A at before surgery, 3 months after surgery and 6 months after surgery (P>0.05). In group B, the level of E2decreased and then increased before surgery, 3 months after surgery and 6 months after surgery, while the levels of LH and FSH increased and then decreased (P<0.05). The levels of LH and FSH in group B were higher than those in group A, and the level of E2was lower than that in group A at 3months after surgery (P<0.05). Compared with group A, the complication rate in group B was significantly decreased, and the difference between groups was statistically significant (P<0.05). The pregnancy rate in group B was higher than that in group A, and the recurrence rate of hysteromyoma was lower than that in group A (P<0.05). There was no significant difference in abortion rate between the two groups (P>0.05). Conclusion: Compared with simple hysteromyoma enucleation, the treatment of hysteromyoma patients combined with laparoscopic uterine vascular occlusion can reduce the intraoperative blood loss, promote the postoperative recovery of patients, and reduce the complication rate and recurrence rate. Although it has a slight and transient impact on ovarian function, it can recover gradually and improve the pregnancy rate. [ABSTRACT FROM AUTHOR]