不同术式对子宫肌瘤患者卵巢功能及性功能的影响

发布时间：2018-05-07 04:40

本文选题：子宫肌瘤 + 腹腔镜子宫肌瘤剔除术　；参考：《中国内镜杂志》2015年05期

【摘要】：目的探讨分析两种手术方式治疗子宫肌瘤对患者卵巢功能及性功能的影响。方法选取2012年1月到2014年3月期间在浙江大学医学院附属妇产科医院进行子宫肌瘤剔除手术的90例患者作为研究对象,根据手术方法进行分组,A组45例患者给予腹腔镜子宫肌瘤剔除术治疗,B组45例患者给予腹腔镜下子宫动脉上行支阻断术辅助腹腔镜子宫肌瘤剔除术治疗。比较两组患者的术中出血量、手术时间、术后排气时间、住院时间以及观察两组患者血清中卵泡刺激素(FSH)和雌二醇(E2)水平、性功能评分。结果 B组患者术中出血量(82.13±13.46)ml、手术时间(59.02±10.18)min明显优于A组患者术中出血量(123.24±18.84)ml、手术时间(70.72±11.63)min,两组比较差异有显著性,(P0.05)。术后3个月B组患者的血清中卵泡刺激素(FSH)(6.95±1.40)IU/L明显高于A组的(6.07±1.22)IU/L,而B组的雌二醇(E2)(72.39±5.62)ng/L明显低于A组的(80.30±5.33)ng/L,差异有显著性(P0.05)。B组患者术后3个月FSH水平比术前高,E2水平比术前低,差异有显著性(P0.05)。A、B两组患者术后6个月的性功能评分明显高于术前,差异有显著性(P0.05);但两组患者术后6个月性功能评分无明显差异,差异无显著性(P0.05)。结论子宫肌瘤患者行腹腔镜下子宫动脉上行支阻断术辅助子宫肌瘤剔除术治疗的效果明显,术中出血少,手术时间短,对患者的卵巢功能的影响只是暂时的,对性功能有明显的改善。
[Abstract]:Objective to investigate the effects of two surgical methods on ovarian function and sexual function in patients with uterine leiomyoma. Methods from January 2012 to March 2014, 90 patients undergoing hysteromyomectomy in the affiliated Obstetrics and Gynecology Hospital of Zhejiang University Medical College were selected as the study subjects. According to the operative method, 45 patients in group A were divided into two groups: group A, 45 patients were treated with laparoscopic myomectomy, group B, 45 patients were treated with laparoscopic uterine artery ascending branch occlusion and laparoscopic hysteromyomectomy. The blood loss, operative time, postoperative exhaust time, hospitalization time, serum FSH and estradiol E2 levels were compared between the two groups. Results in group B, the intraoperative bleeding volume was 82.13 卤13.46 ml, and the operative time was 59.02 卤10.18)min, which was significantly better than that in group A (123.24 卤18.84 ml) and the operative time was 70.72 卤11.63 min. The difference between the two groups was significant (P 0.05). 3 months after operation, the serum level of FSH in group B was 6.95 卤1.40)IU/L higher than that in group A (6.07 卤1.22 渭 mol / L), while the level of estradiol in group B (72.39 卤5.62)ng/L) was significantly lower than that in group A (80.30 卤5.33 ng / L). The level of FSH in group B was significantly lower than that in group B 3 months after operation. The scores of sexual function in group A were significantly higher than those in group B at 6 months after operation, but there was no significant difference in score of sexual function between the two groups at 6 months after operation (P 0.05). Conclusion Laparoscopic uterine artery ascending branch occlusion is effective in the treatment of uterine leiomyomectomy with less bleeding and shorter operation time. The effect on ovarian function is only temporary in patients with uterine leiomyoma. It has obvious improvement on sexual function.
【作者单位】：浙江省安吉县妇幼保健院妇产科;浙江大学医学院附属妇产科医院妇科;
【分类号】：R737.33

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