探讨腹腔镜辅助阴式子宫肌瘤剔除术中3种止血方法的临床效果。

选取2005年2月至2010年8月于本院确诊并住院接受腹腔镜辅助阴式子宫肌瘤剔除术治疗的36例子宫肌瘤患者为研究对象。按照术中止血方法，将其分别纳入子宫动脉阻断组(n＝12，采取子宫动脉阻断术止血)，垂体后叶素组(n＝12，采取垂体后叶素止血)和双极电凝组(n＝12，采取双极电凝术止血)。3组患者年龄、肌瘤数量及直径、月经规律情况等比较，差异无统计学意义(P>0.05)(本研究遵循的程序符合本院人体试验委员会所制定的伦理学标准，得到该委员会批准，分组征得受试对象监护人的知情同意，并与之签署临床研究知情同意书)。

3组手术时间、术后72 h体温、排气时间方面比较，差异均无统计学意义(P>0.05)。3组术中出血量、术后引流量方面比较，差异均有统计学意义(P<0.05)。3组患者住院时间及住院费用方面比较，差异均无统计学意义(P>0.05)。

子宫动脉阻断术在腹腔镜辅助阴式子宫肌瘤剔除术的术中止血效果最佳，亦可根据实际需要，采取多种止血方法联合应用。

To explore the clinical effects of three strategies for hemostasis in laparoscopic-assisted vaginal myomectomy.

From February 2005 to August 2010, a total of 36 women with hysteromyoma who would accept laparoscopic-assisted vaginal myomectomy were included in the study, and were divided randomly into uterine artery occlusion group(n=12), pituitrin group(n=12) and bipolar coagulation group(n=12) based on different strategies for hemostasis during surgery. The study protocol was approved by the Ethical Review Board of Investigation in Human Being of People's Hospital of Macheng. Informed consent was obtained from all participants. There had no significance difference among three groups in ages, pieces and diameters of hysteromyomas, and severity of menstruation irregular etc.(P>0.05).

There had no significant difference among three groups in operation duration, postoperative body temperature at 72 h, and anal exhaust time(P>0.05). There had significant differences among three groups in intraoperative blood loss volume and postoperative drainage volume(P<0.05). there had no significant difference among three groups in hospital stay and its costs(P>0.05).

Uterine artery occlusion is the best intraoperative hemostasis strategy in laparoscopic-assisted vaginal myomectomy. In laparoscopic-assisted vaginal myomectomy, can select others technologies and strategies to promote hemostasis in intraoperative.