腹腔镜子宫肌瘤剔除术与开腹手术对子宫肌瘤患者氧化应激、性功能及预后影响  

Laparoscopic Myomectomy Versus Open Surgery:Impact on Oxidative Stress,Sexual Function,and Prognosis in Patients with Uterine Fibroids

作　　者：张红霞 王凤炜 Zhang Hongxia;Wang Fengwei(The First People's Hospital of Xiangfu District,Kaifeng City,Henan 475100,China)

机构地区：[1]开封市祥符区第一人民医院,河南开封475100

出　　处：《辽宁医学杂志》2025年第1期22-26,共5页Medical Journal of Liaoning

摘　　要：目的旨在比较腹腔镜子宫肌瘤剔除术与开腹手术对子宫肌瘤患者氧化应激、性功能及预后的影响,以为临床治疗提供依据。方法选取开封市祥符区第一人民医院于2021年1月—2023年1月妇科收治的70例子宫肌瘤患者作为研究对象,根据手术方法不同分35例腹腔镜组和35例开腹组,开腹组行开腹子宫肌瘤剔除术,腹腔镜组行腹腔镜子宫肌瘤剔除术。于术前、术后采用女性性功能指数量表(Female Sexual Function Index,FSFI)评估两组患者性功能、并比较两组患者术后7d氧化应激水平[活性氧(ROS)、丙二醇(MDA)、晚期氧化蛋白产物(AOPP)]及术后6个月卵巢储备功能[血清抗苗勒管激素(AMH)、促卵泡激素(FSH)、黄体生成素(LH)、雌二醇(E_(2))]、随访6个月并发症发生率。结果两组患者术后ROS、MDA和AOPP、FSH、LH水平均较术前升高,FSFI评分、AHM及E_(2)水平较术前降低,差异有统计学意义(P<0.05);腹腔镜组患者术后ROS、MDA和AOPP、FSH、LH、E_(2)水平及并发症发生率低于开腹组,FSFI评分及AHM水平高于开腹组,差异有统计学意义(P<0.05)。结论腹腔镜子宫肌瘤剔除术相较于开腹手术,能更有效降低子宫肌瘤患者术后的氧化应激水平、改善性功能和预后,且并发症发生率更低。Objective This study aims to compare the effects of laparoscopic myomectomy and open surgery on oxidative stress,sexual function,and prognosis in patients with uterine fibroids,in order to provide a basis for clinical treatment.Methods A study was conducted on 70 patients with uterine fibroids admitted to the Department of Gynecology at the First People′s Hospital of Xiangfu District,Kaifeng City,from January 2021 to January 2023.The patients were divided into two groups based on the surgical method used:35 in the laparoscopy group and 35 in the laparotomy group.The laparotomy group underwent abdominal myomectomy,while the laparoscopy group underwent laparoscopic myomectomy.The Female Sexual Function Index(FSFI)was used to assess the sexual function of patients in both groups before and after surgery.Additionally,the study compared the levels of oxidative stress markers(reactive oxygen species[ROS],malondialdehyde[MDA],and advanced oxidation protein products[AOPP])7 days after surgery and ovarian reserve function markers(serum anti-Müllerian hormone[AMH],follicle-stimulating hormone[FSH],luteinizing hormone[LH],and estradiol[E_(2)])6 months after surgery,along with the incidence rate of complications during a 6-month follow-up.Results In both groups of patients,the levels of ROS,MDA,AOPP,FSH,and LH were significantly increased post-surgery,while the FSFI scores,AMH,and E_(2) levels were significantly decreased compared to before surgery,with a significant difference(P<0.05).In the laparoscopy group,the post-surgery levels of ROS,MDA,AOPP,FSH,LH,E_(2),and the incidence rate of complications were lower than in the laparotomy group,and the FSFI scores and AMH levels were higher than in the laparotomy group,with a significant difference(P<0.05).Conclusion Laparoscopic myomectomy,compared to open surgery,can more effectively reduce the postoperative oxidative stress levels,improve sexual function and prognosis,and has a lower incidence rate of complications in patients with uterine fibroids.

关 键 词：子宫肌瘤 腹腔镜手术 开腹手术 氧化应激 女性性功能 

分 类 号：R737.33[医药卫生—肿瘤]