腹腔镜下不同术式治疗更年期子宫肌瘤的疗效  

The therapeutic effect of different laparoscopic operations on menopausal uterine fibroids

作　　者：张银光 栾奡 张丽娜 ZHANG Yinguang;LUAN Ao;ZHANG Li'na(Department of Obstetrics and Gynecology,Fengcheng Traditional Chinese Medicine Hospital,Dandong,Liaoning,118100,China)

机构地区：[1]凤城市中医院妇产科,辽宁丹东118100

出　　处：《当代医学》2023年第32期92-96,共5页Contemporary Medicine

摘　　要：目的探究腹腔镜下不同术式治疗更年期子宫肌瘤的疗效。方法选取2018年1月至2020年1月凤城市中医院收治的80例子宫肌瘤患者作为研究对象,根据手术方案不同分为切除术组(n=39)与剔除术组(n=41)。切除术组行腹腔镜下全子宫切除术,剔除术组行腹腔镜下子宫肌瘤剔除术。比较两组围手术期指标、血清性激素[促卵泡生成素(FSH)、雌二醇(E2)、促黄体生成激素(LH)、抗苗勒管激素(AMH)]水平、盆底功能[盆底功能障碍量表(PFDI-20)]、并发症发生情况及子宫肌瘤复发。结果剔除术组术中出血量少于切除术组,手术时间及住院时间均短于切除术组,差异有统计学意义(P<0.05)。术前,两组FSH、E2、LH、AMH水平比较差异无统计学意义;术后3个月,两组FSH、LH水平均高于术前,E2、AMH水平均低于术前,但剔除术组FSH、LH水平均低于切除术组,剔除术组E2、AMH水平均高于切除术组,差异有统计学意义(P<0.05)。术前,两组膀胱、肠道、盆腔评分比较差异无统计学意义;术后3个月,两组膀胱、肠道、盆腔评分均高于术前,但剔除术组低于切除术组,差异有统计学意义(P<0.05)。剔除术组并发症发生率低于切除术组,差异有统计学意义(P<0.05);两组复发率比较差异无统计学意义。结论子宫肌瘤剔除术对更年期子宫肌瘤患者机体损伤更小,可加快术后康复进程,并减缓卵巢功能衰退,且该术式对盆底功能损伤更小,可有效减少并发症的发生。Objective To explore the therapeutic effect of different laparoscopic operations on menopausal uterine fibroids.Methods A total of 80 patients with uterine fibroids admitted to Fengcheng Hospital of Traditional Chinese Medicine from January 2018 to January 2020 were selected as the study subjects,and they were divided into the resection group(n=39)and the excision group(n=41)according to different surgical plans.The resection group was treated with laparoscopic total hysterectomy,and the excision group was treated with myomectomy,the perioperative indexes,serum sex hormone levels(serum anti mullerian hormone[FSH],estradiol[E2],luteinizing hormone[LH],follicle-stimulating hormone[AMH]),pelvic floor function(pelvic floor distress inventory-20[PFDI-20]),complications and uterine fibroid recurrence were compared between the two groups.Results The amount of blood loss in the excision group was less than that in the resection group,and the operation time and hospital stay were shorter than those in the resection group,the differences were statistically significant(P<0.05).Before operation,there were no significant differences in FSH,E2,LH and AMH levels between the two groups;3 months after operation,the levels of FSH and LH of the two groups were higher than before surgery,the levels of E2 and AMH were lower than before operation,but the levels of FSH and LH in the excision group were lower than those in the excision group,and the levels of E2 and AMH in the excision group were higher than those in the resection group,the differences were statistically significant(P<0.05).Before operation,there was no significant difference in bladder,intestinal and pelvic scores between the two groups;at 3 months after surgery,the bladder,intestinal and pelvic scores of the two groups were higher than before operation,but the excision group was lower than the resection group,the differences were statistically significant(P<0.05).The incidence of complications in the excision group was lower than that in the resection group,and the di

关 键 词：腹腔镜 全子宫切除术 子宫肌瘤剔除术 更年期子宫肌瘤 血清性激素水平 

分 类 号：R737.33[医药卫生—肿瘤]