腹腔镜下子宫肌瘤剔除术治疗子宫肌瘤的效果分析

Effect of laparoscopic myomectomy in the treatment of uterine fibroids

目的探讨腹腔镜下子宫肌瘤剔除术治疗子宫肌瘤的临床效果。方法抽取2019年8月至2021年10月开封市妇产医院收治的子宫肌瘤患者86例,按随机数字表法分为对照组与观察组,每组43例。对照组采用经腹子宫肌瘤剔除术,观察组采用腹腔镜下子宫肌瘤剔除术。比较两组围术期情况、炎性因子水平[白细胞介素-6(IL-6)、C反应蛋白(CRP)]、免疫功能[T淋巴细胞亚群(CD3^(+)、CD4^(+))]、应激水平(多巴胺、皮质醇)、血清性激素水平[卵泡刺激素(FSH)、黄体生成素(LH)]及并发症发生率。结果观察组术中出血量少于对照组,胃肠功能恢复时间、住院时间短于对照组,术后3 d VAS评分低于对照组(P<0.05)。术后3 d,观察组IL-6、CRP水平低于对照组(P<0.05),CD3^(+)、CD4^(+)水平高于对照组(P<0.05),多巴胺、皮质醇水平低于对照组(P<0.05),FSH、LH水平低于对照组(P<0.05)。观察组并发症发生率(4.65%,2/43)与对照组(11.63%,5/43)比较差异未见统计学意义(P>0.05)。结论腹腔镜下子宫肌瘤剔除术治疗子宫肌瘤可改善患者围术期情况,减轻炎症刺激、应激反应和对免疫功能的影响,能调节血清性激素水平,且安全性良好。

Objective To investigate the clinical effect of laparoscopic myomectomy in the treatment of uterine fibroids.Methods A total of 86 patients with uterine fibroids treated in Kaifeng Maternity Hospital from August 2019 to October 2021 were selected,and they were divided into control group and observation group according to the random number table method,with 43 cases in each group.The control group was treated by transabdominal myomectomy,and the observation group was treated by laparoscopic myomectomy.The perioperative conditions,levels of inflammatory factors,including interleukin-6(IL-6)and C-reactive protein(CRP),immune function assessed by cluster of differentiation 3+(CD3^(+))and cluster of differentiation 4+(CD4^(+)),stress level assessed by dopamine and cortisol,levels of serum sex hormones,including follicle stimulating hormone(FSH)and luteinizing hormone(LH),and the incidence of complications were compared between the two groups.Results The intraoperative blood loss of the observation group was less than that of the control group,the recovery time of gastrointestinal function and hospital stay were shorter than those of the control group,and the 3-day postoperative visual analogue scale score was lower than that of the control group(P<0.05).Three days after operation,the levels of IL-6 and CRP in the observation group were lower than those in the control group(P<0.05),the levels of CD3^(+)and CD4^(+)in the observation group were higher than those in the control group(P<0.05),the levels of dopamine and cortisol in the observation group were lower than those in the control group(P<0.05),the levels of FSH and LH in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the incidence of complications between the observation group(4.65%,2/43)and the control group(11.63%,5/43),P>0.05.Conclusions Laparoscopic myomectomy in the treatment of uterine fibroids can improve the perioperative condition,reduce inflammatory stimulation,stress response and the impact on immune function,and can regulate the level of serum sex hormones,with good safety.