CAJ | 학술논문

目的：系统评价在腹腔镜子宫动脉阻断术后行子宫肌瘤剥除术的安全性与有效性。方法计算机检索1990年6月至2014年6月国内外公开发表的针对常规腹腔镜下及腹腔镜+子宫动脉阻断术下行子宫肌瘤剥除术疗效的临床对照试验进行系统评价。结果总共纳入13项研究,文献涉及腹腔镜组1168例,腹腔镜+子宫动脉阻断术组1247例。 Meta分析结果提示：与腹腔镜组相比,腹腔镜+子宫动脉阻断术组术中出血量明显减少( WMD=-65．73,95%CI -81．26~-50．19,P<0．01)；术后排气时间缩短(WMD=-65．73,95%CI -81．26~-50．19,P<0．01)；术后住院时间缩短(WMD=-0．64,95%CI -0．98~-0．30,P <0．01)；术后患病率降低(WMD =0．48,95%CI 0．30~0．78,P<0．01)；术后复发率降低(WMD=0．19,95%CI 0．12~0．32,P<0．01)；而手术时间差异无统计学意义(WMD=4．75,95%CI -4．96~14．47,P>0．05)。结论与常规腹腔镜下行子宫肌瘤剥除术相比,腹腔镜+子宫动脉阻断术可以减少术中出血量、缩短术后排气时间及术后住院时间、降低术后复发率及术后患病率,具有较好的临床应用前景。
목적：계통평개재복강경자궁동맥조단술후행자궁기류박제술적안전성여유효성。방법계산궤검색1990년6월지2014년6월국내외공개발표적침대상규복강경하급복강경+자궁동맥조단술하행자궁기류박제술료효적림상대조시험진행계통평개。결과총공납입13항연구,문헌섭급복강경조1168례,복강경+자궁동맥조단술조1247례。 Meta분석결과제시：여복강경조상비,복강경+자궁동맥조단술조술중출혈량명현감소( WMD=-65．73,95%CI -81．26~-50．19,P<0．01)；술후배기시간축단(WMD=-65．73,95%CI -81．26~-50．19,P<0．01)；술후주원시간축단(WMD=-0．64,95%CI -0．98~-0．30,P <0．01)；술후환병솔강저(WMD =0．48,95%CI 0．30~0．78,P<0．01)；술후복발솔강저(WMD=0．19,95%CI 0．12~0．32,P<0．01)；이수술시간차이무통계학의의(WMD=4．75,95%CI -4．96~14．47,P>0．05)。결론여상규복강경하행자궁기류박제술상비,복강경+자궁동맥조단술가이감소술중출혈량、축단술후배기시간급술후주원시간、강저술후복발솔급술후환병솔,구유교호적림상응용전경。
Objective To evaluate the safety and efficacy of laparoscopic myomectomy &uterine artery occlusion( LMUAO) for treating hysteromyoma. Methods A computer-based online search of domestic and international published papers were performed for clinical controlled trials regarding the safety and efficacy of the laparoscopic myomectomy versus LMUAO for hysteromyoma. Results Altogether 13 studies involving 1168 patients who underwent laparoscopic myomectomy and 1247 patients who underwent LMUAO were included. There were no significant difference in operative time ( WMD=4. 75,95% CI= -4. 96-14. 47, P>0.05). However LMUAO had lower intraoperative bleeding(WMD = -65. 73,95% CI -81. 26--50. 19,P<0. 01) ;less postoperative discharge time(WMD = -1. 86,95%CI -2. 97--0. 76,P <0. 01);a shorter time of hospitalization time(WMD= -0. 64,95% CI -0. 98--0. 30,P<0. 01);reduced postoperative morbidity(WMD=0. 48,95%CI 0. 30-0. 78,P<0. 01)and recurrence rate(WMD=0. 19, 95%CI 0. 12-0. 32,P<0. 01). Conclusion Compared with laparoscopic myomectomy,LMUAO can reduce intraoperative bleeding,postoperative discharge time,hospitalization time,postoperative morbidity and recur-rence rate,and it has good clinical application prospect.