全子宫与次全子宫切除术治疗子宫肌瘤对女性卵巢功能的影响

Clinical Analysis of Uterine Fibroids Treated by Total Hysterectomy and Subtotal Hysterectomy for Ovarian Function in Women

目的观察评价腹腔镜下全子宫切除术(laparoscopic total hysterectomy,LTH)与腹腔镜下次全子宫切除术(laparoscopic supercervical hysterectomy,LSH)治疗子宫肌瘤(Uterine fibroids,UF)对女性卵巢功能(Ovarian function,OF)的影响。方法选择2014年6月—2016年6月期间我院收治的126例子宫肌瘤患者,并依据数字表法随机分为两组,对照组63例给予LTH治疗;观察组63例给予LSH治疗,对比分析两组对患者的影响。结果观察组的手术时间、术中出血量、术后肛门排气时间及术后住院时间均少于对照组(P<0.05),术后4周,总并发症发生率,观察组为7.94%,对照组30.16%(X^2=10.0882,P<0.05),术后12周,两组术后AFC与术前比较有统计学差异(P<0.05),但观察组AFC多于对照组(P<0.05),两组血清E_2值显著地低于术前(P<0.05),而观察组高于对照组(t=8.796,P<0.05),血清FSH水平显著地高于术前(P<0.05),而观察组低于对照组(t=36.315,P<0.05)。结论腹腔镜下次全子宫切除术对子宫肌瘤患者的卵巢功能影响较小,安全性较高。

Objective To observe the evaluation laparoscopic total hysterectomy （laparoscopic total hysterectomy, LTH） and next time OF laparoscopie total hysterectomy （laparosCopic supercervical hysterectomy, LSH） treatment OF Uter- ine fibroids （Uterine fibroids, UF） on female Ovarian function （Ovarian function, OF） the curative effect OF value; Meth- ods In June 2014 ~ June 2016 our hospital during the period of 126 patients with uterine fibroids, and on the basis of digit- al meter method, the patients were randomly divided into two groups, control group with 63 cases of LTH treatment, and ob- servation group 63 cases to LSH treatment, compared two groups of curative effect. Results Observation group of operation time, intraoperative blood loss, postoperative anal exhaust time and postoperative hospital stay and significantly less than the control group （ P 〈 0. 05 ）. 4 weeks after surgery, total complication rate observation group was 7.94% , and the control group was 30.16% （ Z2 = 10. 0882, P 〈 0. 05）. 12 weeks after surgery, two groups of postoperative AFC compared with preoperative statistically significant （ P 〈 0. 05 ）, but the observation group AFC was significantly more than the control group （ P 〈 0. 05 ）. The two groups of serum E2 values significantly lower than the preoperative （ P 〈 0. 05）, while the observation group significantly higher than that of the control group （ t = 8. 796, P 〈 0. 05 ）, while serum FSH level significantly higher than that of preoperative （P 〈 0. 05 ） , while the observation group significantly lower than that of the control group （t = 36. 315, P 〈 0. 05 ）. Conclusion Laparoscopic ovarian function of patients with total hysterectomy for uterine fibroids influence is smal- ler, and more security.