腹腔镜全子宫切除术同时预防性双侧输卵管切除的临床探讨  

Clinical analysis on total laparoscopic hysterectomy combined with prophylactic bilateral salpingectomy

作　　者：郭晓霞[1] 杨荣秀[1] 

机构地区：[1]四川省医学科学院.四川省人民医院妇产科,610072

出　　处：《中国妇幼保健》2015年第34期5971-5974,共4页Maternal and Child Health Care of China

摘　　要：目的探讨腹腔镜全子宫切除术同时预防性切除双侧输卵管的可行性及对卵巢功能和围绝经期症状的影响。方法选择因子宫良性疾病行腹腔镜子宫切除术的患者120例,其中同时行双侧输卵管切除术60例为观察组,保留双侧输卵管60例为对照组。观察两组患者手术时间、手术出血量、住院天数、术后肠道功能恢复情况、术后取尿管的时间、术前及术后血清性激素水平、围绝经期症状出现情况。结果 1观察组手术时间(126.39±36.34)min,术中出血量(84.56±53.66)ml,住院(5.34±1.73)d,术后取尿管(2.65±1.03)d,术后肠道功能恢复(37.67±14.25)h;对照组分别为(118.57±38.64)min、(76.84±60.28)ml、(5.81±2.19)d、(2.36±1.17)d、(34.29±12.54)h,两组比较差异无统计学意义(P>0.05)。2观察组术后E21 w、1、3月水平分别为(125.86±42.35)pmol/L、(114.78±36.83)pmol/L、(103.09±32.72)pmol/L,较术前(158.64±32.46)pmol/L显著降低(P<0.05);观察组术后FSH 1 w、1、3月水平分别为(11.24±4.16)m IU/L、(12.92±3.45)m IU/L、(15.07±4.62)m IU/L,LH水平分别为(12.65±3.93)m IU/L、(12.91±3.98)m IU/L、(15.42±4.21)m IU/L,与术前FSH(8.46±3.23)m IU/L、LH(7.86±3.52)m IU/L相比均显著升高(P<0.05);对照组术后上述性激素水平的变化趋势与观察组一致。3观察组术后1 w、1、3月围绝经期症状的发生率分别为25.00%(15/60)、36.66%(22/60)、41.6%(25/60),对照组分别为20.00%(12/60)、31.66%(19/60)、38.33%(23/60),差异无统计学意义(P>0.05)。结论腹腔镜全子宫切除时预防性双侧输卵管切除是一种安全、快速、必要的手术方式,对卵巢功能及围绝经期症状的影响不大,值得在术中应用。Objective To explore the feasibility of total laparoscopic hysterectomy combined with prophylactic bilateral salpingectomy and the effect on ovarian function and perimenopausal symptoms. Methods A total of 120 patients receiving total laparoscopic hysterectomy because of bengn utenne diseases were selected, then they were divided into observation group （ including 60 patients receiving prophylactic bilateral salpingeetomy） and control group （including 60 patients reserving bilateral Fallopian tubes） . The operation time, the a- mounts of blood loss during operation, the hospitalization time, postoperative recovery time of bowel function, postoperative removing catheter time, preoperative and postoperative serum sex hormone levels, and incidence rates of perimenopansal symptoms in the two groups were observed. Results In observation group, the operation time was （ 126. 39±36. 34） minutes, the amount of blood loss during operation was （84. 56±53.66） ml, the hospitalization time was （5.34±1.73） days, postoperative removing catheter time was （2. 65±1.03 ） days, postoperative recovery time of bowel function was （37. 67 ±14. 25 ） hours; while in control group, the operation time, the amount of blood loss during operation, the hospitalization time, postoperative removing catheter time, and postoperative recovery time of bowel function were （118.57±38.64） minutes, （76. 84±60. 28） ml, （5.81 ±2. 19） days, （2. 36±1.17） days, and （34. 29±12. 54） hours, respectively, there was no statistically significant difference between the two groups （ P〉0. 05 ） . The levels of estradiol after one week, one month, and three months of treatment in observation group were （ 125.86±42. 35） pmol/L, （ 114. 78±36. 83） pmol/L, and （ 103.09±32. 72） pmol/L, respectively, which were statistically significantly lower than that before treatment [ （158.64±32.46） pmoL/L] （ P〈0. 05 ） . The levels of follicle-stimulating hormone （FSH） after one week, one month,

关 键 词：腹腔镜 子宫切除术 输卵管 卵巢功能 

分 类 号：R719[医药卫生—妇产科学]