子宫动脉临时阻断在腹腔镜子宫手术中的应用

发布时间：2019-01-10 16:35

【摘要】：目的探讨子宫动脉临时阻断(temporary uterine artery blocking,TUAB)在腹腔镜子宫手术中的应用效果。方法回顾性分析2015年1月~2016年10月实施TUAB的65例资料,其中剖宫产瘢痕妊娠36例,输卵管间质部妊娠16例,子宫肌瘤13例(巨大子宫肌瘤5例,阔韧带肌瘤3例,子宫侧壁肌瘤3例,宫颈肌瘤2例)。先用10号丝线打活结阻断双侧子宫动脉,常规完成手术,抽去结扎线。结果 65例手术均顺利完成,行宫、腹腔镜联合剖宫产瘢痕妊娠物清除+子宫修补术36例,腹腔镜输卵管间质部妊娠物清除+子宫修补术16例,腹腔镜子宫肌瘤剔除术13例,术中出血量分别为(35.0±24.1)ml、(40.0±27.6)ml、(72.3±43.0)ml,手术时间(83.1±23.3)min、(86.8±19.9)min、(91.5±24.3)min,术后住院时间(5.2±1.0)d、(4.9±0.6)d、(5.2±1.0)d。术中无大出血发生。术后盆腔感染1例(1.5%),无其他并发症发生。结论在有大出血风险的腹腔镜子宫手术中行TUAB手术安全,值得推广。
[Abstract]:Objective to investigate the effect of temporary occlusion of uterine artery (temporary uterine artery blocking,TUAB) in laparoscopic uterine surgery. Methods from January 2015 to October 2016, 65 cases of TUAB were retrospectively analyzed, including 36 cases of cesarean scar pregnancy, 16 cases of tubal interstitial pregnancy, 13 cases of uterine leiomyoma (5 cases of giant hysteromyoma, 3 cases of broad ligament leiomyoma). There were 3 cases of uterine lateral myoma and 2 cases of cervical myoma. The bilateral uterine arteries were blocked by 10-wire ligation, then the ligation line was removed. Results 65 cases were successfully completed, 36 cases underwent uterine repair with laparoscopy combined with cesarean scar removal, 16 cases with laparoscopic tubal interstitial pregnancy removal, 13 cases with laparoscopic hysteromyomectomy. Intraoperative bleeding volume was (35.0 卤24.1) ml, (40.0 卤27.6) ml, (72.3 卤43.0) ml, operation time (83.1 卤23.3) min, (86.8 卤19.9) min, (91.5 卤24.3) min, Postoperative hospitalization time was (5.2 卤1.0) d, (, 4.9 卤0.6) d, (, 5.2 卤1.0 d). No major bleeding occurred during the operation. Pelvic infection occurred in 1 case (1.5%), and no other complications occurred. Conclusion TUAB is safe and worth popularizing in laparoscopic uterine surgery with the risk of massive bleeding.
【作者单位】：河南省洛阳市妇女儿童医疗保健中心妇科;
【分类号】：R713.4

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