腹腔镜下传统子宫切除术与保留子宫动脉子宫切除术的疗效比较  

Comparison of the effect between preserving the ascending uterine artery in laparoscopic hysterectmy and traditional laparoscopic hysterectomy

作　　者：汪玉芳 袁慧 柯冬云 罗文平 刘碧玉 谭海燕 

机构地区：[1]广州市白云区第一人民医院妇产科,广东省广州510410

出　　处：《中国基层医药》2013年第1期1-4,共4页Chinese Journal of Primary Medicine and Pharmacy

基　　金：广东省科技计划项目（20100304）

摘　　要：目的 比较腹腔镜下传统子宫切除术与保留子宫动脉子宫切除术的临床疗效。方法因子宫良性病变需要行子宫切除术的112例患者按意愿分为保留子宫动脉上行支的腹腔镜下子宫切除术组（观察组,n=60）和传统腹腔镜下子宫切除术组（对照组,n=52）,比较两组手术时间、术中出血量以及术后并发症发生率,比较两组术前、术后1个月、6个月、1年以及3年血清性激素以及血钙水平,比较观察组术前及术后血流动力学变化,比较两组围绝经期症状。结果 观察组手术时间［（95.5±22.8）min］及术中出血量［（84.3±11.6）ml］明显多于对照组［（86.2±15.5）min、（68.8±7.2）ml］（t=3.772、4.148,均P〈0.01）。观察组术后排尿排便异常（1.7%）及术后发热发生率（1.7%）均明显低于对照组（11.5%、13.5%）（χ2=4.623、5.843,均P〈0.05）。观察组雌二醇水平在术后6个月开始下降，术后6个月、1年、3年与对照组差异均有统计学意义［（328.4±13.4）pmol/L与（304.8±15.2）pmol/L、（311.3±12.9）pmol/L与（248.5±13.6）pmol/L、（258.3±11.4）pmol/L与（138.7±12.7）pmol/L,t=8.758、25.121、52.688,均P〈0.05］。两组卵泡刺激素（FSH）及黄体生成素（LH） 水平术后1、3年差异均有统计学意义（t=－90.540、－123.229、－14.757、－19.845,均P〈001）。两组血钙水平术后1年、3年差异均有统计学意义（t=3.261、3.050，均P〈0.05）。观察组围绝经期症状较对照组少（χ2=6.142、3.471、4.976、6.646、4.633，均P〈0.05）。结论 腹腔镜下保留子宫动脉上行支的子宫切除术是安全可靠的,治疗过程中较大限度地保存了子宫切除患者的卵巢功能,有利于提高妇女生活质量。Objective To compare the clinical effect of preserving the ascending uterine artery in laparoscopic hysterectomy with traditional laparoscopic hysterectomy.Methods 112 patients with various kinds of uterine benign lesions performed by hysterectomy were randomly divided into the preserving the ascending uterine artery in laparoscopic hysterectomy group（observation group,n=60） and traditional laparoscopic hysterectomy group（control group,n=52）,The operation time,the intra operative blood loss,the postoperative complications rate and the perimenopausal symptoms in two groups were compared as well as the levels of blood calcium and the levels of hormone before operation,the first month,the sixth month,the first year,and the third year after operation.Results The opreration time[（95.5±22.8）min]and intraoperative blood soss [（81.3±11.6）ml]of the observation group was more than those of the control group[（68.8±7.2）ml]（t=3.772,4.418,all P〈0.05）.The postoperative abnormal uniation and defection （1.7%） and fever incidence （1.7%） of the observation group was lower than those of the control group（11.5%,13.5%）（χ2=4.623,5.843,all P〈0.05）.The estradiol level of the observation group began to fall in 6 months postoperative, and had significant differences compare with those of the control group 6 months,1 year,3 years after operation[（328.4±13.4）pmol/L vs （304.8 ±15.2）pmol/L,（311.3±12.9）pmol/L vs （248.5±13.6）pmol/L,（258.3±11.4）pmol/L vs （138.7±12.7）pmol/L]（t=8.758,25.121,52.688,all P〈0.05）.There was significant difference in the level of follicle stimulating hormone （FSH） and luteinizing hormone （LH） between the two groups 1,3 years after operation（t=-90.540,-123.229,-14.757,-19.845, all P〈0.01）.There was significant difference in the level of calcium between the two groups 1,3 years after operation（t=3.261,3.050,all P〈0.05）.The perimenopausal symptoms of the observation group was less than those of the control group（χ2=6.1

关 键 词：子宫切除术 腹腔镜 临床对照试验 

分 类 号：R719.8[医药卫生—妇产科学]