腹腔镜子宫肌瘤剔除术与全子宫切除术治疗子宫肌瘤患者的效果比较  

Comparison of effects of laparoscopic myomectomy and total hysterectomy in treatment of patients with uterine fibroids

作　　者：李宁 崔蕾蕾 黄银娟[1] LI Ning;CUI Leilei;HUANG Yinjuan(Second Ward of Department of Obstetrics and Gynecology of the Seventh People’s Hospital of Zhengzhou,Zhengzhou 450000 Henan,China)

机构地区：[1]郑州市第七人民医院妇产科二病区,河南郑州450000

出　　处：《中国民康医学》2025年第4期151-153,157,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:比较腹腔镜子宫肌瘤剔除术与全子宫切除术治疗子宫肌瘤患者的效果。方法:回顾性分析2021—2022年该院收治的60例子宫肌瘤患者的临床资料,根据手术方法不同将其分为对照组和观察组各30例。对照组行腹腔镜全子宫切除术治疗,观察组行腹腔镜子宫肌瘤剔除术治疗,比较两组围手术期指标(术中出血量、肛门排气时间、住院时间)水平,手术前后应激指标[皮质醇(Cor)、去甲肾上腺素(NE)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)]、性激素指标[促黄体生成素(LH)、雌二醇(E_(2))、卵泡刺激素(FSH)、抗米勒管激素(AMH)]水平,以及术后并发症发生率。结果:观察组术中出血量少于对照组,肛门排气时间、住院时间均短于对照组,差异有统计学意义(P<0.05);术后3 d,两组血清Cor、NE、CRP、TNF-α水平均高于术前,但观察组低于对照组,差异有统计学意义(P<0.05);术后6个月,两组血清LH、FSH均高于术前,但观察组低于对照组,两组E_(2)、AMH水平均低于术前,但观察组高于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为6.67%(2/30),低于对照组的26.67%(8/30),差异有统计学意义(P<0.05)。结论:腹腔镜子宫肌瘤剔除术治疗子宫肌瘤患者可改善围手术期指标和性激素指标水平,降低应激指标水平和并发症发生率,效果优于腹腔镜全子宫切除术治疗。Objective:To compare effects of laparoscopic myomectomy and total hysterectomy in treatment of patients with uterine fibroids.Methods:The clinical data of 60 patients with uterine fibroids admitted to this hospital from 2021 to 2022 were retrospectively analyzed.According to different surgical methods,they were divided into control group and observation group,30 cases in each group.The control group was treated with laparoscopic total hysterectomy,while the observation group was treated with laparoscopic myomectomy.The levels of perioperative indexes(intraoperative blood loss,anal exhaust time,hospitalization time),stress indexes[cortisol(Cor),norepinephrine(NE),C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)]and sex hormone indexes[luteinizing hormone(LH),estradiol(E_(2)),follicle stimulating hormone(FSH),anti-Müllerian hormone(AMH)]before and after the surgery,and the incidence of postoperative complications were compared between the two groups.Results:The intraoperative blood loss in the observation group was less than that in the control group,the anal exhaust time and hospitalization time were shorter than those in the control group,and the differences were statistically significant(P<0.05).Three days after the surgery,the levels of serum Cor,NE,CRP and TNF-αin the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Six months after the surgery,the levels of serum LH and FSH in the two groups were higher than those before the surgery,but those in the observation group were lower than those in the control group;the levels of E_(2)and AMH in the two groups were lower than those before the surgery,but those in the observation group were higher than those in the control group;and the differences were statistically significant(P<0.05).Further,the incidence of complications in the observation group was 6.67%(2/30),which was lower than 26.67%(8/30)in the control group,

关 键 词：子宫肌瘤 腹腔镜 子宫肌瘤剔除术 全子宫切除术 应激 性激素 并发症 

分 类 号：R737.3[医药卫生—肿瘤]