腹腔镜与开腹子宫切除术的疗效比较及对卵巢功能影响的研究

The comparing study of therapeutic effects between laparoscopic hysterectomy and open hysterectomy on ovarian function

目的比较腹腔镜子宫全切术与开腹子宫全切术的疗效,以及术后对卵巢功能的影响。方法选择因各种良性子宫疾病需行子宫切除术的患者100例,分为腹腔镜组(50例)和开腹组(50例)。比较两组手术时间、术中出血量、术后排气时间、术后并发症;同时比较两组患者术前及术后3个月、6个月、12个月性激素水平及围绝经期症状。结果腹腔镜组的手术时间、术中出血量、术后排气时间均明显低于开腹组,差异均有统计学意义(P<0.05);两组术后3个月、6个月、12个月血清卵泡刺激素(follicle stimulating hormone,FSH)、黄体生成素(luteinizing hormone,LH)水平升高,雌二醇(estradiol,E2)、孕酮(progesterone,P)水平下降,与术前比较差异均有统计学意义(P<0.05);术后两组围绝经期综合征的发生率比较,差异无统计学意义(P>0.05)。结论子宫切除术后均可影响卵巢功能,腹腔镜子宫全切术效果优于开腹组且未加重对卵巢功能的影响。

Objective To investigate the curative effect comparison of between laparoscopic hysterectomy and open hysterectomy on post - operative ovarian function. Methods One hundred cases because of various benign uterine diseases to be hysterectomized were divided into Laparoscopic Group and Open Group. Then the operating time, blood loss, postoperative exhaust time and postoperative complication were compared between two groups, and comparison between preoperative and postoperative （3,6 and 12 months after surgery） of reproductive hormone level and menopausal symptoms. Results The operating time, blood loss and postoperative exhaust time of laparoscopic group were lower than those of open group and the difference was significant （P 〈 0.05 ）. All the postoperative （3,6 and 12 months after surgery） serum follicle stimulating hormone（FSH） and luteinizing hormone（LH） levels were higher than those of preoperative levels, while estradiol （ E2 ） and progesterone （ P ） levels decreased, and the differences were significant （ P 〈 0.05 ）. The difference of postoperative pcrimenopausal syndrome between the two groups was not significant （ P 〉 0.05 ）. Conclusion Hysterectomy will affect ovarian function. The effect of total Laparoscopic hysterectomy is better than that of open hysterectomy and similar influence to ovarian function.