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研究生:林昆篁
研究生(外文):Kun-Huang Lin
論文名稱:不同治療方法對罹患子宮肌瘤婦女的影響
論文名稱(外文):Use of different approaches in the management of uterine fibroids
指導教授:錢慶文錢慶文引用關係王鵬惠王鵬惠引用關係
指導教授(外文):Ching-Wen ChienPeng-Hui Wang
學位類別:碩士
校院名稱:國立陽明大學
系所名稱:醫務管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2014
畢業學年度:102
語文別:中文
論文頁數:33
中文關鍵詞:腹腔鏡子宮動脈阻斷術腹腔鏡子宮血管阻斷術子宮肌瘤子宮平滑肌瘤
外文關鍵詞:laparoscopic uterine artery occlusionlaparoscopic uterine vessel occlusionfibroidsleiomyomas
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  • 下載下載:19
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目的:比較婦女子宮肌瘤治療其腹腔鏡子宮動脈阻斷術合併子宮-卵巢血管接合阻斷實施的有 (LUVO)、否 (LUAO) 之間的差異。
材料與方法:本研究共收錄 51 位病人。LUVO 組 27 位, LUAO 組 24 位。成效的量測主要比較兩組病人在外科技術 (失血量、手術時間長短、併發症及手術成功率)、病人順從度 (術後疼痛、進食能力、離床自由活動力及重回職場的能力)及手術效力 (症狀管理、症狀緩解、手術的再介入及月經週期的規律度) 的差異。
結果:兩組病人在一般特性項目的比較結果相類似。外科手術技術的比較,兩組病人之間無統計上的差異。相較於 LUVO,LUAO 有術後恢復期較短、疼痛較輕及較早離床自由活動的優勢。一年的成效比較,兩組病人非常相近,無統計上的差異。手術消耗成本費用LUAO 為新台幣三萬五千零九十四元,LUVO 因需合併子宮-卵巢血管接合阻斷手術,需額外耗用四個血管夾共四千八百元 (每個一千二百元),手術消耗成本費用較高為四萬一千九百八十九元,消耗成本費用比較具統計上極顯著的差異。
結論:本研究發現相較於LUVO,進行 LUAO 的婦女其術後恢復較佳、醫療費用較低,又不影響其醫療成效。對於子宮動脈阻斷術合併子宮-卵巢血管接合阻斷實施的有 (LUVO)、否 (LUAO) 之間的差異,是值得進一步探討研究。

Objectives: To determine the short-term effect between laparoscopic uterine artery occlusion without (LUAO) and with (LUVO) simultaneous blockage of anastomosis between the uterine and ovarian vessels in the management of women with fibroids.
Materials and Methods: Fifty-one women with uterine fibroids were analyzed, including 27 women undergoing LUVO and 24 undergoing LUAO. The outcome was measured by comparing surgical technique (blood loss, operative time, complications, and success rate), patient compliance (postoperative pain, tolerance of food intake, free ambulation, and the return to work capability), and outcomes (symptom control, relapse of symptoms, re-intervention, and regularity of menstrual cycles) in both groups.
Results: The general characteristics of the patients were similar in both groups. There were no statistical differences in surgical technique between the two groups. Compared with LUVO, LUAO had some advantages in its rapid postoperative recovery, less pain and earlier free ambulation. One-year outcome of both groups seemed to be similar without statistical difference. As medical cost, patients who received LUAO need to pay for NT 35,094. Patients who received LUVO need to pay extra NT 4,800 for 4 blood clips using in blockage of anastomosis between the uterine and ovarian vessels.
Conclusions: The finding of better recovery and lower medical cost among the patients undergoing LUAO procedure without compromising short-term outcome, compared with LUVO procedure, is worthy of future investigation.

誌謝 i
中文摘要 ii
英文摘要 iv
目錄 vi
圖表目錄 vii
第一章 前言 1
第二章 材料與方法 4
第三章 結果 8
第四章 討論 10
第五章 結論與建議 14
參考文獻 16
附錄 25

表目錄
表1 收錄婦女基本 (一般) 特性比較 28
表2 子宮血管阻斷及部分子宮血管阻斷外科手術術後評估因子比較 29
表3 一年期手術後子宮肌瘤尺寸變化追蹤紀錄比較 30
表4 兩組手術婦女術後一年期間追蹤比較 31
表5兩組手術病人消耗成本費用比較 32

圖目錄
圖1兩組手術病人消耗成本費用比較 33


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