子宫肌瘤不同手术方法治疗对患者卵巢功能和性功能的影响观察

The Effects of Different Surgeries on the Ovarian and Sexual Functions in Patients with Uterine Fibroids

目的:探讨不同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:选取符合标准的患者80例,随机分为观察组和对照组各40例,对照组应用腹腔镜子宫肌瘤剔除术,观察组应用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,比较治疗前后卵巢功能及性功能。结果:观察组手术时间及术中出血量明显优于对照组,差异有显著性(P<0.05);二者术后排气时间及术后住院时间相似,差异无统计学意义(P>0.05)。观察组术后3个月血清FSH水平较术前升高,E2水平较术前下降,差异有显著性(P<0.05);术后6个月血清FSH及E2水平与术前相似,差异无统计学意义(P>0.05)。对照组术前、术后3个月及术后6个月血清FSH及E2水平相似,差异无统计学意义(P>0.05)。术后3个月观察组血清E2水平低于对照组,FSH高于对照组,差异有显著性(P<0.05)。术后6个月,两组患者性功能较术前均明显改善,差异有显著性(P<0.05),组间比较差异无统计学意义(P>0.05)。结论: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对卵巢功能的影响是暂时性的,具有可逆性,显著改善性功能。

Objective：To investigate the effects of different surgeries on the ovarian and sexual functions in patients with uterine fibroids .Method：80 eligible patients were selected and randomly divided into obser-vation group and control group , 40 patients each group;the control group was treated with laparoscopic myo-mectomy , while the observation group treated with laparoscopic blockage of ascending branch of uterine arter -ies assisted by laparoscopic myomectomy , and the pre-therapeutic and post-therapeutic ovarian functions and sexual functions were compared .Result：The operative time and intra-operative blood loss of the obser-vation group were significantly better than those of the control group , and the differences were statistically significant （P〈0.05）; The postoperative passing-flatus times and postoperative lengths of stay of the two groups were similar , and the differences were statistically insignificant （ P〉0.05） .In the observation group , 3 months after the surgery , the serum FSH level was higher than that before the surgery , while the E2 level was lower than that before the surgery , and the differences were statistically significant （ P〈0.05 ）; in 6 months after the surgery , the serum FSH and E 2 levels were similar with those before the surgery , and the differences were statistically insignificant （ P〉0.05） .In the control group , the serum FSH and E 2 levels be-fore the surgery , in 3 months after the surgery and in 6 months after the surgery were similar , and the differ-ences were statistically insignificant （P〉0.05）.In 3 months after the surgeries, the serum E2 level of the ob-servation group was lower than that of the control group , while the FSH level of the observation group was higher than that of the control group , and the differences were statistically significant （ P〈0.05 ） .6 months after the surgeries , the sexual functions of the patients of the two groups were significantly improved when compared with those before the surgeries , the differences of both groups were statistically significant （ P〈0. 05）, and the difference between the two groups was statistically insignificant （P〉0.05）.Conclusion：Lapa-roscopic blockage of ascending branch of uterine arteries assisted by laparoscopic myomectomy has temporary and reversible effects on ovarian function , and can significantly improve sexual function .