腹腔镜全子宫切除术对子宫肌瘤患者近期疗效及并发症影响  

Short-term efficacy of laparoscope total hysterectomy for treating patients with uterine fibroids and its influence on the complications

作　　者：王璐璐 徐莉[1] WANG Lulu;XU Li(Taihe County People's Hospital,Fuyang,Anhui Province,236600)

机构地区：[1]安徽省太和县人民医院,236600

出　　处：《中国计划生育学杂志》2025年第3期581-584,590,共5页Chinese Journal of Family Planning

摘　　要：目的:探讨腹腔镜全子宫切除术治疗子宫肌瘤效果,及对患者创伤应激、卵巢功能等的影响。方法:回顾性收集2021年11月-2023年11月本院收治的子宫肌瘤患者178例临床资料,其中采用经腹子宫切除术患者89例纳入开腹组,采用腹腔镜子宫切除术的患者89例纳入腹腔镜组,比较两组围术期指标、卵巢功能指标、创伤应激指标、疼痛情况、生活质量及并发症情况。结果:腹腔镜组术中出血量(76.14±9.78ml)、术后排气(16.14±2.28h)、住院时间(6.02±1.14d)、手术时间(72.85±8.38min)均少于开腹组,术后1个月时孕酮(15.36±2.58 nmol/L)、促黄体生成素(23.01±3.07 mIU/ml)、雌二醇(121.13±13.26 pmol/L)、卵泡刺激素(9.76±1.51mIU/ml)水平均高于开腹组,术后1天时皮质醇(266.12±28.63 mmol/L)、去甲肾上腺素(241.58±25.45 U/ml)水平以及术后12 h、术后24 h VAS评分(3.86±0.45分、2.66±0.32分)均低于开腹组,生活质量综合评定问卷评分(93.07±9.74分)高于开腹组(88.65±8.92分),并发症发生率(5.6%)低于开腹组(21.4%)(均P<0.05)。结论:采用腹腔镜辅助全子宫切除术治疗子宫肌瘤,可减少手术对患者卵巢功能影响,减轻创伤应激指标及机体疼痛,利用患者术后恢复,术后生活质量改善效果更佳,临床应用效果较好。Objective:To investigate the effect of laparoscope-assisted total hysterectomy for treating patients with uterine fibroids,and to study its influence on the traumatic stress and ovarian function of the patients.Methods:The clinical data of 178 patients with uterine fibroids admitted to the hospital from November 2021 to November 2023 were collected retrospectively.89 patients who had undergone the abdominal hysterectomy were included in the control group,and 89 patients who had undergone laparoscopic-assisted hysterectomy were included in the study group.The perioperative indicators,the ovarian function indicators,the trauma stress indicators,the pain situation,the quality of life and the complications of the patients were compared between the two groups.Results:The intraoperative blood loss(76.14±9.78ml),the postoperative exhaust time(16.14±2.28h),the hospitalization time(6.02±1.14d)and the operation time(72.85±8.38min)of the patients in the study group were significantly less than those of the patients in the control group.The levels of progesterone(15.36±2.58 nmol/L),luteinizing hormone(23.01±3.07 mIU/ml),estradiol(121.13±13.26 pmol/L)and follicle-stimulating hormone(9.76±1.51mIU/ml)of the patients in the study group in l month after operation were significantly higher than those of the patients in the control group.The levels of cortisol(266.12±28.63 mmol/L)and norepinephrine(241.58±25.45 U/ml)of the patients in the study group in 1 day after operation,and the VAS scores of the patients in the study group in 12h and in 24h after operation(3.86±0.45 points and 2.66±0.32 points)were significantly lower than those of the patients in the control group.The comprehensive quality of life assessment questionnaire score(93.07±9.74 points)of the patients in the study group was significantly higher than that(88.65±8.92 points)of the patients in the control group.The incidence of the complications(5.6%)of the patients in the study group was significantly lower than that(21.4%)of the patients in the control

关 键 词：子宫肌瘤 腹腔镜全子宫切除术 手术指标 卵巢功能 创伤应激 生活质量 并发症 

分 类 号：R73[医药卫生—肿瘤]