多途径超声监测腹腔镜子宫肌瘤剔除术的价值研究

发布时间：2018-05-03 23:13

本文选题：子宫肌瘤 + 超声检查　；参考：《现代妇产科进展》2017年10期

【摘要】：目的:探讨在腹腔镜子宫肌瘤剔除术围手术期,多途径超声动态监测的临床价值。方法:行腹腔镜下子宫肌瘤剔除术的患者169例,围手术期应用腹部、阴道或直肠超声以及腹腔内超声动态监测。术前,腹部超声、阴道超声可评估子宫肌瘤的特征。术中应用多途径超声监测肌瘤位置、指引剔除。应用阴道超声评估肌瘤残留情况。结果:169例腹腔镜子宫肌瘤剔除术患者中,共剔除肌瘤721枚,其中非超声引导剔除肌瘤431枚,超声引导多剔除肌瘤282枚,术中结合宫腔镜剔除肌瘤8枚。超声引导下避免穿透子宫内膜患者37例,发现肌瘤部位血肿3例,发现盆腔隐匿病灶5例。应用"挑出法"剔除子宫肌瘤156枚,占肌瘤切除总数的21.63%。结论:腹腔镜下子宫肌瘤剔除术围手术期,应用多途径超声动态监测,可有效减少肌瘤残留,判断肌瘤的剔除方式,避免术中损伤子宫内膜,及时发现血肿病灶,减少围手术期并发症。"挑出法"是超声引导剔除3型、4型小肌瘤的有效方法。
[Abstract]:Objective: to evaluate the clinical value of multi-channel ultrasonic dynamic monitoring in the perioperative period of laparoscopic hysteromyomectomy. Methods: laparoscopic hysteromyomectomy was performed in 169 patients. Abdominal, vaginal or rectal ultrasound and intraperitoneal ultrasound were used in the perioperative period. Preoperative abdominal ultrasound and vaginal ultrasound can be used to evaluate the characteristics of uterine leiomyoma. Multi-channel ultrasound was used to monitor the location of myoma during the operation. The residual status of leiomyoma was evaluated by vaginal ultrasound. Results among 169 cases of laparoscopic hysteromyomectomy, 721 leiomyomas were removed, including 431 leiomyomas under non-ultrasound guidance, 282 leiomyomas by ultrasound guidance, and 8 leiomyomas by intraoperative hysteroscopy. Under the guidance of ultrasound, 37 cases of endometrium were avoided, 3 cases of hematoma and 5 cases of occult pelvic lesions were found. 156 uterine leiomyomas were removed by "pick out method", accounting for 21.63% of total myomectomy. Conclusion: during the perioperative period of laparoscopic hysteromyomectomy, dynamic monitoring with multi-channel ultrasound can effectively reduce the residual of myoma, judge the removal mode of myoma, avoid the injury of endometrium during the operation, and find the hematoma focus in time. Reduce perioperative complications. " The method of picking out is an effective method for the removal of type 3 and 4 small leiomyoma by ultrasonic guidance.
【作者单位】：青岛大学;青岛大学附属医院妇科;
【分类号】：R737.33

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