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腹腔镜子宫肌瘤剔除术在临床中的应用
http://www.100md.com 《腹腔镜外科杂志》 2006年第6期
腹腔镜;肌瘤剔除术;保留子宫;子宫肌瘤,,腹腔镜;肌瘤剔除术;保留子宫;子宫肌瘤,1资料与方法,2结果,3讨论,参考文献:
     【摘要】 目的:为要求微创保留子宫的年轻患者,寻找一种子宫肌瘤剔除术的好方法,进一步研究LM术(laparoscopic myomectomy,LM)的优越性。方法:脑垂体后叶素6U用50ml生理盐水稀释后,子宫肌层注射,用电刀纵向切开表面肌层,切口选择肌瘤最凸出处,其长度视肌瘤大小而定,一般小于肌瘤直径1~3cm,用抓钳钳夹肌瘤牵拉,电钩切断肌瘤与假包膜连接致密处,将肌瘤完整剔除,尽可能减少切断肌层及血管,以减少出血。子宫切口用1号可吸收线连续缝合止血,腹腔镜组用子宫粉碎器将肌瘤粉碎取出。术后常规持续静脉点滴催产素24h共30U。结果:腹腔镜组与开腹组出血量差异无显著意义,排气时间、离床活动时间及术后住院时间差异有显著意义。结论:LM是肌壁间子宫肌瘤年轻患者理想的手术方式。

    【关键词】 腹腔镜;肌瘤剔除术;保留子宫;子宫肌瘤

    Clinical application of laparoscopic myomectomy

    SHENG Xiaobin.

    Beijing Shijingshan Hospital,Beijing 100043,China

    【Abstract】 Objective:To seek better surgical procedure to remove uterine fibroids by means of laparoscope for young patients who want to preserve the intact uterus and to discover its advantages.Methods:Prepare neurohypophyseal hormone 6 unit that has been diluted by 50ml salty water,and inject it into the muscular wall of the uterus.Then with an electrical knife cut the muscular wall of the uterus lengthways,from where the fibroid is most protruding.The incision,based on the size of the fibroids,is usually about 13 cm shorter than the fibroids diameter in length.Afterwards,draw the fibroids with a grasping pincer and cut with an electrical claw to remove the intact fibroids from the false membrane.To avoid too much bleeding,attention should be paid to cut the muscles and blood vessels as little as possible.No.1 absorbable thread is used for a continuous suture on the incision to stop bleeding.In laparoscopic myomectomy group,fibroids are broken by crumbling instrument and then taken out from the uterus.A routine vein injection of Ecbolic 30U is required for 24h after operation.Results:Between the two groups of laparoscopic myomectomy and abdominal myomectomy,remarkable difference can be found in intestinal gas expelling time,leaving bed time and leaving hospital time,but no remarkable difference in bleeding.Conclusions:Laparoscopic myomectomy can be recommended as an appropriate surgical type to young patients with uterine fibroids for removal of the fibroids growing in the muscular wall of the uterus. ......

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