腹腔镜下子宫动脉阻断术联合子宫肌瘤剔除术治疗子宫肌瘤的临床效果及对卵巢储备功能的影响  

Clinical effect of laparoscopic uterine artery occlusion combined with myomectomy in the treatment of uterine fibroids and its influence on ovarian reserve function

作　　者：武春艳 李晨 任华 刘换霞 WU Chunyan;LI Chen;REN Hua;LIU Huanxia(Gynecology and Obstetrics Department,Xi'an Daxing Hospital,Xi'an 710000,China)

机构地区：[1]西安大兴医院妇产科,陕西西安710000

出　　处：《临床医学研究与实践》2024年第30期65-68,共4页Clinical Research and Practice

摘　　要：目的探讨腹腔镜下子宫动脉阻断术联合子宫肌瘤剔除术治疗子宫肌瘤的临床效果及对卵巢储备功能的影响。方法选择2021年8月至2022年8月西安大兴医院妇产科收治的90例子宫肌瘤患者作为研究对象,按照随机数字表法将其分为对照组(n=45,腹腔镜子宫肌瘤剔除术)和观察组(n=45,在对照组基础上联合腹腔镜下子宫动脉阻断术)。比较两组的手术效果。结果观察组的手术时间长于对照组,术中出血量少于对照组,首次排气时间短于对照组(P<0.05)。术后2、3个月,两组的促卵泡生成素(FSH)、促黄体生成素(LH)、雌二醇(E_(2))及抗苗勒管激素(AMH)水平均低于术前(P<0.05)。术后2个月,两组的卵巢体积、血流峰值速度(PSV)小于术前,窦卵泡数量(AFC)少于术前(P<0.05)。术前及术后2、3个月,两组的FSH、LH、E_(2)、AMH、卵巢体积、PSV、AFC水平比较,差异无统计学意义(P>0.05)。观察组的子宫肌瘤复发率为4.44%,低于对照组的20.00%(P<0.05)。结论腹腔镜下子宫动脉阻断术联合子宫肌瘤剔除术治疗子宫肌瘤患者可以减少术中出血量,且不会影响卵巢储备功能,有利于改善患者的预后。Objective To investigate the clinical effect of laparoscopic uterine artery occlusion combined with myomectomy in the treatment of uterine fibroids and its influence on ovarian reserve function.Methods A total of 90 patients with uterine fibroids admitted in gynecology and obstetrics department of Xi'an Daxing Hospital from August 2021 to August 2022 were selected as the research objects.According to the random number table method,the patients were divided into control group(n=45,laparoscopic myomectomy)and observation group(n=45,combined with laparoscopic uterine artery occlusion on the basis of the control group).The surgical effects of the two groups were compared.Results The operation time of the observation group was longer than that of the control group,the intraoperative blood loss was less than that of the control group,and the first exhaust time was shorter than that of the control group(P<0.05).At 2 and 3 months after operation,the levels of follicle-stimulating hormone(FSH),luteinizing hormone(LH),estradiol(E_(2))and anti-Mullerian hormone(AMH)in the two groups were lower than those before operation(P<0.05).At 2 months after operation,the ovarian volume and peak systolic velocity(PSV)of the two groups was less than that before operation,and the antral follicle count(AFC)was less than that before operation(P<0.05).There were no significant differences in the levels of FSH,LH,E_(2),AMH,ovarian volume,PSV and AFC between the two groups before operation and at 2 and 3 months after operation(P>0.05).The recurrence rate of uterine fibroids in the observation group was 4.44%,which was lower than 20.00%in the control group(P<0.05).Conclusion Laparoscopic uterine artery occlusion combined with myomectomy in the treatment of patients with uterine fibroids can reduce intraoperative blood loss,and will not affect the ovarian reserve function,which is conducive to improving the prognosis of patients.

关 键 词：腹腔镜 子宫动脉阻断术 子宫肌瘤剔除术 子宫肌瘤 卵巢储备功能 

分 类 号：R737.33[医药卫生—肿瘤]