MURU对子宫腺肌病患者子宫血流动力学影响的初步研究

发布时间：2018-07-12 13:49

本文选题：MURU + 子宫腺肌病　；参考：《遵义医学院》2016年硕士论文

【摘要】：目的:研究“肌壁大部切除-子宫重建术”(MURU)对子宫腺肌病患者子宫血流动力学的影响。方法:以超声测量单侧子宫肌壁厚度或腺肌瘤最大直径(MD)为标准,将子宫腺肌病患者分为三度(轻度、中度、重度)。选取无生育要求的中、重度或经其他治疗方法失败的子宫腺肌病患者15例行MURU术(观察组),并于术中放置左旋炔诺孕酮宫内缓释系统(LNG-IUS)。选取同期子宫肌壁间肌瘤患者15例行子宫肌瘤剔除术(对照组)。分别于术前、术后1月、术后3月、术后6月及术后12月以彩色多普勒超声测量子宫动脉收缩期血流速度峰值(PSV)、舒张期末血流速度(EDV)、动脉搏动指数(PI)、阻力指数(RI)及子宫体积。结果:MURU组及子宫肌瘤剔除组手术过程均顺利,术中、术后均无并发症发生。①两组患者术前、术后子宫动脉显示率良好,频谱多普勒图形态均呈高速高阻型。肌瘤剔除组及MURU组术后1月、3月、6月、12月的PSV、EDV值均较术前减小(P0.05);两组患者术后1月、3月、6月、12月组间比较,PSV、EDV值无明显变化(P0.05);将两组PSV、EDV分别在术前、术后各时间点分别比较,差异无统计学意义(P0.05)。肌瘤剔除组及MURU组术后1月、3月、6月、12月的PI、RI值较术前均无明显改变(P0.05);两组患者术后1月、3月、6月、12月组间比较,PI、RI值无明显变化(P0.05);将两组PI、RI分别在术前、术后各时间点分别比较,差异无统计学意义(P0.05)。②子宫肌瘤剔除组及MURU组术后子宫体积均较术前明显缩小,缩小至正常子宫体积大小相似(P0.05);术后各时间点相互比较,两组患者子宫体积均无明显改变(P0.05);两组间各时间点分别比较,两组患者子宫体积差异无统计学意义(P0.05)。结论:MURU手术在观察时间内对子宫腺肌病患者的子宫血流动力学不造成明显影响,但远期影响需进一步追踪。
[Abstract]:Objective: to study the effects of subtotal musculectomy and uterine reconstruction (muu) on uterine hemodynamics in patients with adenomyosis. Methods: patients with adenomyosis were divided into three degrees (mild, moderate and severe) according to the criteria of measuring the thickness of unilateral uterine muscle wall or the maximum diameter (MD) of adenomyoma. Fifteen patients with moderate, severe or failed uterine adenomyosis with no fertility requirement were treated with Muru (observation group), and the intrauterine sustained release system (LNG-IUS) of levonorgestrel (LNG-IUS) was placed during the operation. 15 patients with intramural myoma were treated with myomectomy (control group). The peak systolic velocity (PSV), end-diastolic velocity (EDV), pulsatility index (Pi), resistance index (RI) and uterine volume were measured by color Doppler ultrasound before, 1 month, 3 months, 6 months and 12 months after operation respectively. Results the operation process of the two groups was smooth. There were no complications in both groups. The uterine artery was displayed well before operation and the pattern of spectrum Doppler was high speed and high resistance. The values of PSV EDV in the leiomyomatous removal group and muu group were significantly lower than those in the preoperative group (P0.05), and there was no significant difference between the two groups in the 1st, 3rd, 6th and 12th months after operation (P0.05); the PSVV titration EDV values in the two groups were compared before operation and at each time point after operation, respectively. The difference was not statistically significant (P0.05). There was no significant change in Pi RI in myomectomy group and muu group at 1 month, 3 months, 6 months and 12 months after operation (P0.05), but there was no significant change in Pi RI between the two groups at 1 month, 3 months, 6 months and 12 months after operation (P0.05). There was no significant difference at each time point after operation (P0.05). 2 the uterine volume in the uterine myoma knockout group and the Muru group were significantly reduced to the normal uterine volume size (P0.05); the postoperative time points were compared with each other. There was no significant change in uterine volume between the two groups (P0.05); there was no significant difference in uterine volume between the two groups (P0.05). Conclusion during the observation period, the uterine hemodynamics of the patients with adenomyosis was not significantly affected by the operation of VW Muru, but the long-term effects need to be further followed up.
【学位授予单位】：遵义医学院
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R713.4

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