腹腔镜子宫全切术与开放手术对子宫肌瘤患者性激素及性功能的影响

Effects of laparoscopic hysterectomy and laparotomy on sex hormones and sexual function in patients with hysteromyoma

目的评价腹腔镜子宫全切术与开放手术对子宫肌瘤患者性激素及性功能的影响。方法将100例子宫肌瘤患者随机分为A组和B组,各50例。A组给予腹腔镜子宫全切术;B组给予开放手术。比较两组的手术指标、性激素及性功能。结果与B组比较,A组术中出血量更少,手术时间、术后下床活动时间及住院时间明显更短(P<0.05)。术后1周,两组血清促卵泡激素(FSH)、黄体生成素(LH)水平均升高,孕酮(P)、雌二醇(E_2)水平均降低(P<0.05);与B组比较,A组FSH、LH水平更低,P、E_2水平更高(P<0.05);术后1个月,B组的性功能评分降低,且低于A组(P<0.05)。结论腹腔镜子宫全切术治疗子宫肌瘤创伤较轻,且对性激素及性功能的影响较小。

Objective To evaluate the effects of laparoscopic hysterectomy and laparotomy on sex hormones and sexual function in patients with hysteromyoma. Methods A total of 100 patients with hysteromyoma were randomly divided into group A and group B, with 50 cases in each group. The group A was treated with laparoscopic hysterectomy, and the group B was given laparotomy. The surgical index, sex hormone and sexual function were compared between the two groups.Results Compared with the group B, there were less blood loss, shorter operation time, time to get out of bed and hospital stays in the group A（P〈0.05）. At 1 week after operation, the follicle stimulating hormone（FSH） and luteinizing hormone（LH） levels increased, and the progesterone（P） and estradiol（E2） levels decreased in the two groups（P〈0.05）. Compared with the group B, there were lower FSH, LH levels and higher P, E2 levels in the group A（P〈0.05）. At 1 month after operation, the score of sexual function of the group B decreased, and lower than that of the group A（P 〈0.05）. Conclusion Laparoscopic hysterectomy is less traumatic in the treatment of hysteromyoma, and it has little effect on sex hormone and sexual function.