腹腔镜下肿瘤剔除术治疗子宫肌瘤的效果分析  

Analysis of the effect of laparoscopic tumor resection in the treatment of uterine fibroids

作　　者：张光娟 ZHANG Guang-juan(Department of Obstetrics and Gynecology,Huangdao District Third People's Hospital,Qingdao 266400,China)

机构地区：[1]山东省青岛市黄岛区第三人民医院妇产科,266400

出　　处：《中国实用医药》2023年第4期58-61,共4页China Practical Medicine

摘　　要：目的探讨腹腔镜下肿瘤剔除术治疗子宫肌瘤的临床效果。方法58例子宫肌瘤患者,随机分为甲组和乙组,每组29例。甲组采用常规开腹手术治疗,乙组采用腹腔镜下肿瘤剔除术治疗。比较两组患者手术时间、住院时间、出血量,并发症发生率,血流灌注、毛细血管管径、甲襞微循环中的管襻形态积分、血液流态积分,抗缪勒管激素(AMH)、卵泡刺激素(FSH)水平。结果两组手术时间、住院时间比较,差异无统计学意义(P>0.05);乙组出血量(83.25±10.25)ml少于甲组的(120.23±10.39)ml,差异具有统计学意义(P<0.05)。手术前,两组AMH、FSH水平比较,差异无统计学意义(P>0.05);手术后,乙组AMH水平(1.91±0.25)ng/ml高于甲组的(1.80±0.13)ng/ml,FSH水平(20.14±1.25)U/L低于甲组的(23.15±1.62)U/L,差异具有统计学意义(P<0.05)。手术前,两组血流灌注、毛细血管管径及甲襞微循环中的管襻形态积分、血液流态积分比较,差异无统计学意义(P>0.05);手术后,乙组血流灌注(0.93±0.15)V小于甲组的(1.45±0.23)V,毛细血管管径(7.52±0.15)μm大于甲组的(6.15±0.33)μm,甲襞微循环中的管襻形态积分(0.68±0.11)分、血液流态积分(0.61±0.03)分均低于甲组的(0.99±0.09)、(1.05±0.11)分,差异具有统计学意义(P<0.05)。乙组并发症发生率3.45%低于甲组的20.69%,差异具有统计学意义(P<0.05)。结论采用腹腔镜下肿瘤剔除术治疗子宫肌瘤对患者的卵巢功能、宫颈微循环的影响轻微,术后患者恢复较快,且安全性也更高,临床可推广。Objective To discuss the clinical effect of laparoscopic tumor resection in the treatment of uterine fibroids.Methods A total of 58 patients with uterine fibroids were randomly divided into group A and group B,with 29 cases in each group.Group A was treated by conventional open surgery,and group B was treated by laparoscopic tumor resection.Both groups were compared in terms of operative time,hospital stay,blood loss,complication rate,blood perfusion,capillary tube diameter,capillary loop morphology score in the nail fold microcirculation,blood flowing state score and anti-müllerian hormone(AMH)and follicle stimulating hormone(FSH)levels.Results There was no statistically significant difference between the two groups in terms of operative time and hospital stay(P>0.05).The amount of blood loss(83.25±10.25)ml in group B was less than(120.23±10.39)ml in group A,and the difference was statistically significant(P<0.05).Before surgery,there was no statistically significant difference in the levels of AMH and FSH between the two groups(P>0.05).After surgery,the AMH level(1.91±0.25)ng/ml in group B was higher than(1.80±0.13)ng/ml in group A,and the FSH level(20.14±1.25)U/L was lower than(23.15±1.62)U/L in group A.The differences were statistically significant(P<0.05).Before surgery,there was no statistically significant difference between the two groups in terms of blood perfusion,capillary tube diameter,capillary loop morphology score in the nail fold microcirculation,blood flowing state score in the nail fold microcirculation(P>0.05).After surgery,the blood perfusion(0.93±0.15)V in group B was lower than(1.45±0.23)V in group A,and the capillary tube diameter(7.52±0.15)μm was larger than(6.15±0.33)μm in group A;the capillary loop morphology score and blood flowing state score in the nail fold microcirculation in group B were(0.68±0.11)and(0.61±0.03)points,which were lower than(0.99±0.09)and(1.05±0.11)points in group A;the differences were statistically significant(P<0.05).The complication rate in group

关 键 词：腹腔镜下肿瘤剔除术 子宫肌瘤 宫颈微循环 抗缪勒氏管激素 

分 类 号：R737.33[医药卫生—肿瘤]