腹式子宫腺肌病病灶切除术联合子宫动脉阻断术治疗子宫腺肌病76例临床观察

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摘要目的比较腹式子宫腺肌病病灶切除术与子宫腺肌病病灶切除术联合子宫动脉阻断术治疗子宫腺肌病的效果。方法选取2013年3月～2014年11月本院收治的76例欲保留生育功能的子宫腺肌病患者作为研究对象，随机分成对照组和观察组，各38例。对照组采用单纯腹式子宫腺肌病病灶切除术治疗，观察组采用腹式子宫腺肌病病灶切除术联合子宫动脉阻断术。比较两组术后3、6、12个月的相关临床指标，分析评估病灶切除术联合子宫动脉阻断术的疗效。结果观察组术后的痛经VAS评分显著低于对照组，差异有统计学意义（P＜0.01）。观察组术后的痛经缓解率显著高于对照组，差异有统计学意义（P＜0.05）。观察组术后的痛经无效率显著低于对照组，差异有统计学意义（P＜0.05）。观察组的复发率显著低于对照组，差异有统计学意义（P＜0.05）。观察组的月经量减少发生率显著高于对照组，差异有统计学意义（P=0.03）。观察组术后3、6个月的抗苗勒氏管激素（AMH）水平显著低于对照组，差异有统计学意义（P＜0.01）。两组术后12个月的AMH水平比较，差异无统计学意义（P＞0.05）。结论子宫腺肌病病灶切除联合子宫动脉阻断术治疗子宫腺肌病效果确切，不影响卵巢功能，与单纯的子宫腺肌病病灶切除术相比，痛经消失和缓解率及月经量减少效果更佳，并且可减少1年内的复发，相对技术难度较低，适合在基层医院推广应用。

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	李丽晶
	邱扬
	黄铭君

关键词 ：子宫腺肌病, 子宫动脉阻断术, 妇科外科手术, 保守性手术

Abstract：Objective To compare the effect between trans-abdominal adenomyomectomy and trans-abdominal adenomyomectomy combined with uterine artery blockage（UAB）in the treatment of patientswith uterine adenomyosis.Methods 76 patients diagnosed with circumscribed adenomyosis from March 2013 to November 2014 in our hospital were selected as the research group，all of the enrolled patients requested to preserve their reproductive function.All patients were randomly divided into the control group and the observation group，38 cases in each group.The control group was treated with trans-abdominal adenomyomectomy，the observation group was treated with trans-abdominal adenomyomectomy combined with UAB.The related clinical indexes of the two groups after operation at 3，6，12monthswas compared，and the efficacy of the trans-abdominal adenomyomectomy combined with UAB was evaluated.Results The post-operative VASscores of dysmenorrheal in the observation group was lower than that in the control group，with significant difference（P＜0.01）.The remission rate of dysmenorrhea in the observation group was higher than that in the control group，with significant difference　（P＜0.05）.The ineffective or exacerbation rate of dysmenorrhea in the observation group was lower than that in the control group，with significantdifference　（P＜0.05）.The recurrence rate of the observation group was lower than that of the control group，with significant difference（P＜0.05）.The incidence rate ofmenstrual blood loss in the observation group was higher than that in the control group，with significant difference　（P=0.03）.The level of AMH after operation at 3，6 months in the observation group was lower than that in the control group，with significant difference（P＜0.05）.There was no significant difference in the level of AMH after operation at 12months between the two groups（P＞0.05）.Conclusion Trans-abdominal adenomyomectomy combined with UAB has satisfying effectiveness and has no reverse impact on ovarian function.Comparing with simple trans-abdominal adenomyomectomy，it has a superior efficacy in extinguishing and relieving dysmenorrhea，reducingmenstrual blood loss and recurrent rate within one year after surgery.This surgery has good feasibility in primary hospitals because of itsmoderate technical difficulty.

Key words： Adenomyosis Uterine artery blockage surgery Gynecologic surgical surgery Conservative surgery

基金资助:广东省江门市科技计划项目（2013019）

引用本文:

李丽晶；　邱扬；　黄铭君. 腹式子宫腺肌病病灶切除术联合子宫动脉阻断术治疗子宫腺肌病76例临床观察[J]. 中国当代医药, 2016, 23(26): 64-67.
LILi-jing；QIU Yang；HUANGMing-jun. Clinical observation of the trans-abdom inal adenom yomectom y combined with uterine artery blockage in the treatment of 76 patients with uterine adenom yosis. 中国当代医药, 2016, 23(26): 64-67.

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