| 摘要: |
| 【】目的 探究彩超检测子宫肌瘤假包膜到浆膜面最短距离(Myometrial free margin,MFM)在宫、腹腔镜去除Ⅱ型子宫黏膜下肌瘤中的应用。方法 选取我院在2014年12月至2016年12月期间收治的、符合纳入标准的Ⅱ型子宫黏膜下肌瘤226例。根据手术方法的不同,分为宫腔镜组(n=114)和腹腔镜组(n=112)。对比两组MFM、肿瘤直径、肿瘤位置、手术时间、术中出血量、手术费用等情况；术后随访6个月,记录患者月经变化、贫血例数、肌瘤复发、妊娠例数等情况。结果 经我院术后病理检测,所有患者的Ⅱ型子宫黏膜下肌瘤均为良性肌瘤。两组的MFM、肿瘤直径、肿瘤数量、肿瘤位置无明显差异(P>0.05)；宫腔镜组的子宫肌瘤包膜到黏膜面最短距、手术时间、术中出血量、术后血红蛋白差值、住院天数及住院费用均较低,差异具有统计学意义(t=13.98、13.39、6.60、13.54、4.47、22.55,P<0.01)；随访6个月后,宫腔镜组月经改善情况较好(χ2=18.48,P<0.01),两组血红蛋白值均恢复正常。结论 宫腔镜子宫肌瘤电切术能缩短手术时间,减少术中出血量并减轻患者经济负担。对于肌瘤直径＜65mm,且MFM≤5mm的患者,行宫腔镜治疗是安全、有效的。 |
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| DOI： |
| 投稿时间：2017-03-26修订日期：2017-06-11 |
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| Application of MFM in the removal of type II submucousal fibroids by hysteroscopy or laparoscopy |
| qiushuping |
| (Zhuji city central hospital of shaoxing city in zhejiang province) |
| Abstract: |
| objective To analysis the application of MFM in the removal of type II submucousal fibroids by hysteroscopy or laparoscopy. Method 226 patients with type II submucousal fibroids from December 2014 to December 2016 in our hospital were collected and analyzed clinical data.According to the different surgical methods, the patients were divided into hysteroscopy group (n=114) and laparoscopic group (n=112).The MFM, tumor diameter, tumor location, operation time, intraoperative blood loss, operation costs were compared in two groups.The patients were followed up for 6 months. The changes of menstruation, anemia, recurrence and pregnancy were recorded.Result All the patients were diagnosed as benign tumor after operation.There was no significant difference in MFM, tumor diameter, tumor number and tumor location between the two groups (P>0.05).Length of the fibroids pseudocapsule to uterine mucosa, operation time, intraoperative blood loss, postoperative hemoglobin difference, hospitalization days and hospitalization costs in hysteroscopy group were lower than that in laparoscopic group(t=13.98,13.39,6.60,13.54,4.47,22.55,P<0.01).After 6 months, the improvement of menstruation was better (χ2=18.48, P<0.01), and the hemoglobin values in the two groups were normal.Conclusion Hysteroscopic resection of uterine fibroids can shorten operation time and reduce intraoperative blood loss and the economic burden of patients. Hysteroscopy treatment is safe and effective in the diameter of fibroids <65mm, and the MFM≤5mm. |
| Key words: Type II submucousal fibroids MFM Color Doppler ultrasonography Hysteroscopy Laparoscopy |
