腹腔镜下子宫肌瘤微创剔除术治疗子宫肌瘤的疗效及对患者应激反应的影响  

Efficacy of laparoscopic minimally invasive removal of uterine fibroids in the treatment of uterine fibroids and its effect on patients'stress response

作　　者：袁静 胡昌华[1] 李琦[1] 肖波[1] 梅春秀 肖菊 YUAN Jing;HU Changhua;LI Qi;XIAO Bo;MEI Chunxiu;XIAO Ju(Department of Obstetrics,Hanyang Hospital,Wuhan University of Science and Technology,Wuhan,Hubei,430050,China)

机构地区：[1]武汉科技大学附属汉阳医院产科,湖北武汉430050

出　　处：《当代医学》2022年第16期72-74,共3页Contemporary Medicine

摘　　要：目的探究腹腔镜下子宫肌瘤微创剔除术治疗子宫肌瘤的疗效及对患者应激反应的影响。方法选取2017年1月至2020年6月本院收治的68例子宫肌瘤患者作为研究对象,按照交替分组法分为两组,每组34例。开腹组采用开腹子宫肌瘤剔除术,腹腔镜组采用腹腔镜手术。比较两组手术指征(手术时间、术中出血量、术后初次排气时间及住院时间)和术前、术后1 d应激反应[去甲肾上腺素(NE)、醛固酮(ALD)及皮质素(Cor)]及术后并发症发生情况(切口感染、盆腔粘连、肠梗阻)。结果腹腔镜组手术时间长于开腹组,术中出血量少于开腹组,术后初次排气时间及住院时间均短于开腹组,差异有统计学意义(P<0.05)。术后1 d,两组ALD、NE、Cor水平均高于术前,且腹腔镜组ALD水平高于开腹组,NE、Cor水平均低于开腹组,差异有统计学意义(P<0.05)。腹腔镜并发症发生率低于开腹组,差异有统计学意义(P<0.05)。结论腹腔镜下子宫肌瘤微创剔除术治疗子宫肌瘤效果显著,能够促进患者术后恢复,并发症少,应激反应轻,值得临床推广应用。Objective To explore the effect of laparoscopic minimally invasive removal of uterine fibroids on uterine fibroids and its effect on patients'stress response.Methods 68 patients with uterine fibroids who were admitted to our hospital from January 2017 to June 2020 were selected as the research subjects,and they were divided into two groups according to the alternate grouping method,with 34 cases in each group,the open group underwent minimally invasive removal,and the laparoscopy group underwent laparoscopic surgery.The surgical indications(operation time,intraoperative blood loss,postoperative initial exhaust time and hospital stay)and preoperative and postoperative 1 d stress response(norepinephrine[NE],aldosterone[ALD]and corticosteroid[Cor])and postoperative complications(incision infection,pelvic adhesions,intestinal obstruction)were compared between the two groups.Results The operation time of the laparoscopy group was longer than that of the open group,the intraoperative blood loss was less than that of the open group,and the postoperative initial exhaust time and hospital stay were shorter than those of the open group,and the difference was statistically significant(P<0.05).At 1 d after operation,the levels of ALD,NE,and Cor in the two groups were higher than those before operation,and the ALD level in the laparoscopic group was higher than that in the open group,and the levels of NE and Cor were lower than those in the open group,and the difference was statistically significant(P<0.05).The incidence of laparoscopic complications was lower than that of the open group,and the difference was statistically significant(P<0.05).Conclusion Laparoscopic minimally invasive removal of uterine fibroids has remarkable effect in the treatment of uterine fibroids,can promote postoperative recovery of patients with fewer complications and mild stress response,which is worthy of clinical application.

关 键 词：腹腔镜 子宫肌瘤剔除术 子宫肌瘤 应激反应 

分 类 号：R737.33[医药卫生—肿瘤]