不同手术方案对子宫肌瘤患者卵巢储备功能的影响

Efficacy of different surgical procedures on ovarian reserve functions in patients with uterine fibroids

目的探讨不同手术方案对子宫肌瘤患者卵巢储备功能的影响。方法选取2014年1月至2015年1月间接受手术治疗的子宫肌瘤患者150例,按照随机数字表法分为腹腔镜下子宫全切除组、腹腔镜下子宫次全切组和开腹组,每组各50例。分析各组患者的手术时间、术中出血量以及术前、术后1个月、术后2个月促卵泡成熟激素(FSH)、雌二醇(E2)的水平。结果腹腔镜下全切组患者手术时间为102.3 min,术中出血量为(123.6±3.2)ml;腹腔镜下次全切组患者手术时间为120.2 min,术中出血量为(105.4±4.1)ml;开腹组患者手术时间为72.3 min,术中出血量为(150.3±2.1)ml,各组患者的手术时间和术中出血量等方面差异有统计学意义(P<0.05)。术后1个月,各组患者FSH水平值均显著降低,且差异有统计学意义(P<0.05);术后1个月,各组患者E2水平值显著降低,且差异有统计学意义(P<0.05);但术前、术后2个月E2水平差异无统计学意义(P>0.05)。结论腹腔镜下子宫次切除手术方案能够显著减少术中出血量,改善患者的卵巢储备功能。

Objective To study the efficacy of different surgical procedures on ovarian reserve function in patients with uterine fibroids. Methods From January 2014 to January 2015,150 patients with uterine fibroids were enrolled in the study and they were randomly divided inti laparoscopic hysterectomy group,laparoscopic uterine total resection group and laparotomy group,50 cases in each group. The operation time,intraoperative bleeding, were compared between the three groups. The levels of follicle-stimulating hormone（ FSH） and estradiol（ E2） preoperative and postoperative 1 mo,after 2 mo were compared between the three groups. Results The operation time and amount of bleeding in the laparoscopic resection group were 102. 3 min and（ 123. 6 ± 3. 2） ml. Those in the laparoscopic next time total resection group were 120. 2 min and（ 105. 4 ± 4. 1） ml and laparotomy group 72. 3 min,（ 150. 3 ± 2. 1） ml. The operative time and bleeding amount between the three groups showed significant differences（ P 〈 0. 05）. Postoperative 1 mo,FSH levels in the three groups decreased significantly and FSH levels in the three groups showed significant difference（ P 〈 0. 05）; Postoperative 1 mo,serum levels of E2 between the three groups decreased significantly and showed significant difference（ P 〈 0. 05）. Preoperative and postoperative 2 mo,the level of E2 showed no significant difference（ P 〉 0. 05）. Conclusion Laparoscopic surgery can significantly reduce the amount of bleeding and improve the ovarian reserve function in patients.