腹腔镜下全子宫切除术对子宫肌瘤患者性激素及血清炎性因子水平的影响  

Effect of Total Hysterectomy Under Laparoscopic Surgery on the Levels of Sex Hormones and Serum Inflammatory Factors in Patients with Uterine Fibroids

作　　者：张现蕾[1] ZHANG Xianlei(Department of Obstetrics and Gynecology,People's Hospital of Taishan District,Tai'an,Shandong Province,271000 China)

机构地区：[1]泰安市泰山区人民医院妇产科,山东泰安271000

出　　处：《系统医学》2021年第22期174-177,共4页Systems Medicine

基　　金：山东医药卫生科技发展计划项目(2018WS496)。

摘　　要：目的探究腹腔镜下全子宫切除术对子宫肌瘤患者性激素及血清炎性因子水平的影响。方法选取2018年1月—2020年6月该院接受医治的99例子宫肌瘤患者作为研究对象,分组依据随机数表法将其分为对照组(50例)和观察组(49例)。对照组进行开腹全子宫切除术,观察组采用腹腔镜下全子宫切除术。术后两组均予以常规抗感染治疗,且术后观察72 h。出院后两组随访两个月。比较两组围术期情况;术前、术后2个月性激素水平及术前、术后72 h血清IL-6、CRP、D-D水平。结果观察组手术时间、肛门排气时间分别为(64.53±11.87)min、(27.53±4.69)h,短于对照组(76.43±16.97)min、(36.13±5.27)h,观察组术中出血量(57.39±30.06)mL少于对照组(96.95±48.16)mL,差异有统计学意义(t=4.035、8.571、4.891,P<0.05);两组较术前,术后2个月血清FSH和LH水平均降低,且观察组血清FSH和LH水平分别为(96.47±6.44)mIU/mL、(35.26±2.71)mIU/mL,低于对照组(102.06±9.48)mIU/mL、(48.73±2.04)mIU/mL;而血清E2水平升高,观察组E_(2)(209.41±17.06)pg/mL高于对照组(175.16±13.51)pg/mL,差异有统计学意义(t=3.425、27.978、11.086,P<0.05);与术前比较,术后72 h两组患者血清IL-6、CRP和D-D水平均升高,观察组血清IL-6、CRP和D-D水平分别为(20.34±2.18)ng/L、(7.75±3.24)mg/L、(4.09±0.18)mg/L低于对照组(22.26±3.08)ng/L、(11.41±3.33)mg/L、(4.28±0.37)mg/L,差异有统计学意义(t=3.574、5.541、3.238,P<0.05)。结论腹腔镜下全子宫切除术可明显缩短子宫切除手术时间和肛门排气时间,改善术中出血情况和术后性激素水平,同时相比于开腹全子宫切除术,腹腔镜下全子宫切除术对机体炎症反应的刺激较轻微,更利于缓解患者高凝状态。Objective To explore the effect of laparoscopic total hysterectomy on the levels of sex hormones and serum inflammatory factors in patients with uterine fibroids.Methods Selected 99 patients with uterine fibroids treated from January 2018 to June 2020 in the hospital as the study object.They were divided into the control group(50 cases)and the observation group(49 cases),and the grouping was based on the random number table method.The control group underwent open hysterectomy,and the observation group underwent laparoscopic hysterectomy.Both groups were treated with routine anti-infection after operation,and they were observed for 72 hours after operation.The two groups were followed up for 2 months after discharge.The perioperative conditions of the two groups were compared;the levels of sex hormones before and 2 months after the operation,and the levels of serum IL-6,CRP,and D-D at 72 h before and after the operation.Results The operation time and anal exhaust time of the observation group were(64.53±11.87)min and(27.53±4.69)h,shorter than those of the control group(76.43±16.97)min and(36.13±5.27)h.The intraoperative blood loss of the observation group(57.39±30.06)mL was less than that of the control group(96.95±48.16)mL.The difference was statistically significant(t=4.035,8.571,4.891,P<0.05).The levels of serum FSH and LH in both groups were lower than before and 2 months after operation.The serum FSH and LH levels in the observation group were(96.47±6.44)mIU/mL and(35.26±2.71)mIU/mL,lower than those in the control group(102.06±9.48)mIU/mL and(48.73±2.04)mIU/mL.The serum E2 level in the observation group(209.41±17.06)pg/mL was higher than that in the control group(175.16±13.51)pg/mL.The difference was statistically significant(t=3.425,27.978,11.086,P<0.05).Compared with before operation,serum IL-6,CRP and D-D levels in 2 groups were increased 72 h after operation.The levels of IL-6,CRP and D-D in the observation group were(20.34±2.18)ng/L,(7.75±3.24)mg/L and(4.09±0.18)mg/L,lower than those in th

关 键 词：子宫肌瘤 腹腔镜下子宫切除术 性激素 炎性因子 

分 类 号：R711[医药卫生—妇产科学]