腹腔镜子宫肌瘤剔除术在临床中的应用

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1、腹腔镜子宫肌瘤剔除术在临床中的应用【关键词】腹腔镜；肌瘤剔除术；保留子宫；子宫肌瘤【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—步研究LM术(laparoscopicmyomectomy,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，用电刀纵向切开表而肌层，切口选择肌瘤最凸出处，其长度视肌瘤大小而定，--般小于肌瘤直径l~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IIUflLo子宫切口用1号对吸收线连续缝合止血，腹腔镜组用子宫粉碎器

2、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、离床活动时间及术片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ClinicalapplicationoflaparoscopicmyomectomySHENGXiaobin.BeijingShijingshanHospital,Beijing100043,China【Abstract]Objective:Toseekbettersurgicalproceduretoremov

3、euterinefibroidsbymeansoflaparoscopeforyoungpatientswhowanttopreservetheintactuterusandtodiscoveritsadvantages.Methods:Prepareneurohypophysealhormone6unitthathasbeendilutedby50mlsaltywater5andinjectitintothemuscularwalloftheuterus.Thenwithanelectricalknifecutthemuscularwalloftheuteru

4、slengthways,fromwherethefibroidismostprotnjding.Theincision,basedonthesizeofthefibroidsjsusuallyabout13cmshorterthanthefibroidsdiameterinlength.Afterwards,drawthefibroidswithagraspingpincerandcutwithanelectricalclawtoremovetheintactfibroidsfromthefalsemembrane.Toavoidtoomuchbleeding,

5、attentionshouldbepaidtocutthemusclesandbloodvesselsaslittleaspossible.No.1absorbablethreadisusedforacontinuoussutureontheincisiontostopbleeding.Inlaparoscopicmyomectomygroup,fibroidsarebrokenbycrumblinginstrumentandthentakenoutfromtheuterus.AroutineveininjectionofEcbolic30Uisrequired

6、for24hafteroperation.Results:Betweenthetwogroupsoflaparoscopicmyomectomyandabdominalmyomectomy,remarkabledifferencecanbefoundinintestinalgasexpellingtimejeavingbedtimeandleavinghospitaltime,butnoremarkabledifferenceinbleeding.Conclusions:Laparoscopicmyomectomycanberecommendedasanappr

7、opriatesurgicaltypetoyoungpatientswithuterinefibroidsforremovalofthefibroidsgrowinginthemusculai*walloftheuterus・【Keywords]Laparoscopy;Myomectomy;Topreservetheuterus;Uterinefibroids随着社会的发展，人们对健廉理念认识水平的捉高，对丁•子宫肌瘤的患者，尤其是年轻患者，不仅要求微创手术，还要求保留子宮。从1999年我们釆用具有创伤小、恢复快等优点的腹腔镜手术，对52例患有肌壁间及浆膜下子宫

8、肌瘤的年轻患者，施行•腹