摘要
目的探讨假包膜内旋切术式(intracapsular rotary-cut procedure,IRCP)用于切除宫颈肌瘤的可行性和安全性。方法对2013年1月至2022年9月在北京大学深圳医院住院接受手术切除的宫颈肌瘤54例患者的临床资料进行回顾性分析,其中24例患者采用IRCP作为研究组,30例患者采用传统肌瘤切除术式作为对照组。IRCP采用最小化的子宫切口,在假包膜内进行旋转切割并牵拉瘤体,保留假包膜的神经纤维和血管组织。收集两组患者的手术及预后相关指标并进行比较。结果两组患者的年龄、体质指数、手术方式比较,差异均无统计学意义(P>0.05)。两组患者的生育史、症状、术前置入双J管率、术中因出血量导致输血、术后转重症监护室、术后并发症和腹腔镜中转开腹比较,差异均无统计学意义(P>0.05)。两组患者的宫颈肌瘤直径、手术时间比较,差异均无统计学意义(P>0.05)。研究组患者术后发热(4.2%,1/24)与对照组(30.0%,9/30)比较,差异有统计学意义(P<0.05)。研究组患者的住院时间中位数[5.0 d(4.0 d,6.8 d)]和术中出血中位数[95.0 mL(20.0 mL,137.5 mL)]与对照组[7.0 d(6.0 d,8.3 d),275.0 mL(200.0 mL,400.0 mL)]比较,差异有统计学意义(P<0.001)。结论RICP对治疗宫颈肌瘤是安全可行的。其子宫切口长度短,术后发热率低,住院时间短,术中出血量少,手术创伤小,保护患者宫颈结构的完整性。
Objective To explore the feasibility of intracapsular rotary-cut procedure(IRCP)for treating cervical fibroids.Methods It is a retrospective study conducted in Peking University Shenzhen Hospital(PUSH),54 patients who were treated with cervical fibroids in PUSH from January 2013 and September 2022 were enrolled in this study.Among them,24 patients were treated with IRCP as the study group,while the other 30 patients were treated with the conventional myomectomy procedure as the control group.The technique of IRCP include minimized uterine incision,rotary cuttings in the fibroid inside the pseudocapsule,holding the fibroid with forceps and pulling it outward,preserving the nerve fibers and vessels of the fibroid pseudocapsule.By collecting and comparing the surgical and prognostic indicators of the two groups of patients,any significant differences were identified.Results There was no significant difference in age,body mass index,and surgical method between the two groups(P>0.05).There was no significant difference between the two groups of patients in terms of reproductive history,symptoms,preoperative double J tube insertion rate,intraoperative blood transfusion due to blood loss,postoperative transfer to intensive care unit,postoperative complications and change of surgical method(laparoscopy to transabdominal)(P>0.05).There was no significant difference in the fibroid diameter and operation time between the two groups(P>0.05).Compared to the control group,patients in the study group had a significantly lower incidence of postoperative fever(4.2%vs 30.0%,P<0.05),shorter median length of hospital stay[5.0 d(4.0 d,6.8 d)vs 7.0 d(6.0d,8.3d),P<0.000],and less median intraoperative blood loss[95.0 mL(20.0 mL,137.5 mL)vs 275.0 mL(200.0 mL,400.0 mL),P<0.000].Conclusions IRCP is safe and feasible for the treatment of cervical fibroids as it is associated with the shorter uterine incision length,fewer postoperative fever,shorter hospital stay,less operation bleeding,less surgical trauma,and preservation of the patient’s cervical structure.
作者
彭燕婷
曾荔苹
吴瑞芳
PENG Yanting;ZENG Liping;WU Ruifang(Department of Obstetrics and Gynecology,Peking University Shenzhen Hospital;Institute of Obstetrics and Gynecology,Shenzhen PKU-HKUST Medical Center,Shenzhen,518035,China)
出处
《中国妇产科临床杂志》
CSCD
2023年第2期154-157,共4页
Chinese Journal of Clinical Obstetrics and Gynecology
基金
深圳市高水平医院建设专项经费资助(粤办函[2019]260号)
深圳市医学重点学科建设经费资助(SZXK027)
深圳市“医疗卫生三名工程”项目资助(SZSM202011016)。
关键词
宫颈肌瘤
假包膜内旋切肌瘤法
传统肌瘤切除术式
疗效
安全性
cervical fibroid
intracapsular rotary-cut procedure
conventional myomectomy procedure
efficacy
safety
