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可吸收宫颈止血带在子宫肌瘤剔除术中应用后子宫血管变化的三维能量多普勒研究。

Three-dimensional power Doppler study of changes in uterine vascularity after absorbable cervical tourniquet during open myomectomy.

机构信息

Department of Obstetrics and Gynecology, Faculty of Medicine, Zagazig University Hospitals, Zagazig, Egypt.

出版信息

Arch Gynecol Obstet. 2011 Jul;284(1):157-61. doi: 10.1007/s00404-010-1615-x. Epub 2010 Aug 12.

Abstract

OBJECTIVE

To evaluate the effect of an absorbable polyglactin tie (i.e., cervical tourniquet) on postoperative uterine artery blood flow using three-dimensional (3D) power Doppler.

PATIENTS AND METHODS

Forty-four patients with symptomatic uterine myomas warranting surgical treatment were randomized to either receive absorbable cervical tourniquets group 1 or not group 2. Resistance index, pulsatility index, and peak systolic velocity of the uterine artery as well as 3D power Doppler study of uterine vascularity in terms of VI, FI, vascularization flow index (VFI) were performed preoperatively and at 1 and 3 months, postoperatively. Estimated myoma and uterine volume, operative time were compared in both groups.

RESULTS

No significant difference in the characteristics of myomas, regarding number, size, and location of the largest myoma, between the two studied groups. No significant differences between the two groups for uterine artery RIs, PIs, and PSV at 1 and 3 months, postoperatively. The myometrial VI, FI and VFI in the study group were comparable to those in the control group. No sequential change in FI was noted in either group.

CONCLUSION

Absorbable cervical tourniquet during open myomectomy did not compromise uterine perfusion as evaluated by 3D power Doppler study.

摘要

目的

使用三维(3D)能量多普勒评估可吸收聚甘醇酸结扎(即宫颈止血带)对术后子宫动脉血流的影响。

患者和方法

44 名患有症状性子宫肌瘤需要手术治疗的患者被随机分为两组,一组接受可吸收宫颈止血带(组 1),另一组不接受(组 2)。术前及术后 1 个月和 3 个月时,分别检测子宫动脉阻力指数(RI)、搏动指数(PI)和收缩期峰值流速(PSV)以及 3D 能量多普勒的子宫血管血流参数,包括血管化指数(VI)、血流指数(FI)和血管化血流指数(VFI)。比较两组患者的肌瘤和子宫体积、手术时间。

结果

两组患者的肌瘤特征(肌瘤数量、大小和最大肌瘤位置)无显著差异。术后 1 个月和 3 个月,两组子宫动脉 RI、PI 和 PSV 无显著差异。研究组子宫肌层的 VI、FI 和 VFI 与对照组相当。两组 FI 均无序列变化。

结论

在开放性子宫肌瘤剔除术中使用可吸收宫颈止血带不会影响 3D 能量多普勒评估的子宫灌注。

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