腹腔镜下子宫肌瘤剔除术治疗多发性子宫肌瘤的疗效及预后研究  

The effect and prognosis of laparoscopic myomectomy in the treatment of multiple uterine myomas

作　　者：寇明菊 Kou Ming-ju(Department of Obstetrics and Gynecology,Xinyang Third People's Hospital,Xinyang 464000,Henan,China)

机构地区：[1]信阳市第三人民医院妇产科,河南信阳464000

出　　处：《四川生理科学杂志》2024年第7期1616-1618,共3页

摘　　要：目的:分析腹腔镜下子宫肌瘤剔除术对多发性子宫肌瘤的疗效及预后的影响。方法:回顾性收集2020年11月至2023年5月期间于本院行手术治疗的94例多发性子宫肌瘤患者的临床资料。按照手术治疗方法的不同,将患者分为剔除组(行腹腔镜下子宫肌瘤剔除术,47例)和全切组(行腹腔镜下子宫全切术,47例)。分析对比两组的围术期指标(手术时间、术中出血量、术后首次肛门排气时间以及首次下床活动时间),术前、术后第1个卵泡期卵巢功能(采用雌二醇(Estradiol,E2)、促卵泡生成激素(Follicle stimulating hormone,FSH)以及促黄体生成激素(Luteinizing hormone,LH)指标变化评价),并查阅两组患者术后资料,统计住院期间术后并发症发生情况。结果:剔除组手术时间、术后首次肛门排气时间以及首次下床活动时间均显著短于全切组,术中出血量显著少于全切组(P<0.05)。较术前,两组术后第7 d的E2水平显著下降,FSH、LH水平均显著升高,但剔除组的E2水平显著高于全切组,FSH、LH均显著低于全切组(P<0.05)。剔除组并发症发生率低于全切组,但组间比较无统计学差异(P>0.05)。结论:与子宫全切术相比,腹腔镜下子宫肌瘤剔除术治疗多发性子宫肌瘤,创伤性小,对卵巢功能的影响小,且术后并发症少,更利于患者术后康复。Objective:To analyze the effect and prognosis of laparoscopic myomectomy for multiple uterine myomas.Methods:Clinical data of 94 patients with multiple uterine fibroids who underwent surgical treatment in our hospital from November 2020 to May 2023 were retrospectively collected.According to different surgical treatment methods,patients were divided into an exclusion group(47 cases underwent laparoscopic myomectomy)and a total hysterectomy group(47 cases underwent laparoscopic total hysterectomy).Perioperative indicators,ovarian function(estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH)),and complications between two groups were analyzed and compared.Results:The surgical time,first postoperative anal exhaust time,and first time getting out of bed activity in the exclusion group were significantly shorter than those in the total resection group,and the intraoperative bleeding was significantly less than that in the total resection group(P<0.05).Compared to before surgery,the E2 levels of both groups significantly decreased on the 7th day after surgery,while the FSH and LH levels significantly increased.However,the E2 levels in the exclusion group were significantly higher than those in the total resection group,while the FSH and LH levels were significantly lower than those in the total resection group(P<0.05).The incidence of complications in the exclusion group was lower than that in the total resection group,but there was no statistical significant difference between the groups(P>0.05).Conclusion:Compared with total hysterectomy,laparoscopic myomectomy for the treatment of multiple uterine fibroids has less trauma,less impact on ovarian function,and fewer postoperative complications,which is more conducive to patient recovery.

关 键 词：多发性子宫肌瘤 腹腔镜 子宫肌瘤剔除术 子宫全切术 卵巢功能 并发症 

分 类 号：R737.33[医药卫生—肿瘤]