腹腔镜下不同术式对子宫肌瘤患者疗效及生活质量的影响

Influences of different laparoscopic surgical procedures on curative effect and quality of life of patients with hysteromyoma

目的探讨腹腔镜下不同术式对子宫肌瘤患者疗效及生活质量的影响。方法选取64例无生育要求的子宫肌瘤患者为研究对象,采用随机数字表法将其分为观察组和对照组,各32例。对照组予以腹腔镜次全子宫切除术,观察组予以腹腔镜子宫肌瘤剥除术。比较两组患者术后子宫肌瘤残留率及随访期内复发率,记录手术前、术后6个月性功能评分及性激素指标变化情况。结果术后6个月,观察组FSFI评分及性激素指标与术前比较,差异无统计学意义(P>0.05);对照组患者上述指标均低于术前,差异有统计学意义(P<0.05)。在12个月的随访中,对照组无子宫肌瘤复发报告,观察组复发3例(9.4%),两组比较,差异无统计学意义(P>0.05)。结论对子宫肌瘤患者予以腹腔镜子宫肌瘤剥除术,能最大程度地保留其卵巢功能,对术后生活质量影响较小,值得临床推广。

Objective To investigate the influences of different laparoscopic surgical procedures on curative effect and quality of life of patients with hysteromyoma. Methods 64 patients with hysteromyoma and without the need of reproduction were selected as study objects. According to the random number table,the patients were divided into observation group and control group,32 cases in each group. Patients in control group were treated with laparoscopic sub-total hysterectomy,and patients in observation group were treated with laparoscopic hysteromyoma decollement. The residual rates of hysteromyoma and recurrence rates in follow-up period were compared between the two groups. The sexual function scores and changes of sex hormones before operation and 6 months after operation were recorded. Results 6 months after operation,there were no significant differences in FSFI score and sex hormone indexes in the observation group,compared with those before operation（ P〉0. 05）; The above indexes in the control group were significantly lower than those before operation（ P〈0. 05）; During the 12 months of follow-up,there was no recurrence of hysteromyoma in control group,while in the observation group,there were 3 cases of recurrence（ 9. 4%）（ P〉0. 05）. Conclusion To adopt laparoscopic hysteromyoma decollement in patients with hysteromyoma can maximize the retention of their ovarian function,which has less effect on postoperative quality of life. It is worthy of clinical promotion.