三种方式子宫切除术治疗子宫肌瘤患者的疗效及对女性卵巢功能的影响

Effect of three-way Hysterectomy on Uterine Leiomyoma and its Influeace on Ovarian Function in Women

目的:探讨阴式子宫切除术、腹腔镜下子宫切除术及经腹子宫切除术治疗子宫肌瘤患者的疗效及对女性卵巢功能的影响。方法:选择2014年3月至2017年3月子宫肌瘤行子宫切除术患者60例作为研究对象,根据手术方式的不同分为阴式子宫切除术(阴式组)、腹腔镜下子宫切除术(腔镜组)和经腹子宫切除术(经腹组)各20例。比较各组患者的临床治疗效果各指标,治疗前及治疗6个月后的E2、FSH、LH水平、卵巢功能评分、总体性功能评分变化情况,统计围绝经期症状及性生活障碍发生率。结果:阴式组的手术时间、出血量、肛门排气时间、住院时间及总费用明显少于经腹组,且出血量、住院时间及总费用明显少于其他两组,差异均有统计学意义(P<0.05);治疗后6个月与治疗前比较,三组患者的E2水平均显著降低,而FSH及LH水平显著升高,三组患者的E2、FSH及LH水平存在明显差异(P<0.05);治疗后三组患者的卵巢功能评分均升高,而总体性功能评分均降低,且阴式组、腔镜组的总体性功能评分均明显高于经腹组(P<0.05);三组患者治疗后的围绝经期症状及性生活障碍发生率无明显差异(P>0.05)。结论:三种方式子宫切除术均会对患者卵巢功能造成一定负面影响,阴式子宫切除术对患者临床效果较好,对患者的卵巢功能影响较小。值得推广。

Objective:To evaluate the efficacy of vaginal hysterectomy,laparoscopic hysterectomy and abdominal hysterectomy in the treatment of uterine fibroids and its effect on female ovarian function.Methods:Sixty patients who underwent hysterectomy for uterine fibroids treated in our hospital from March 2014 to March 2017(with a three-year increase in time span)were selected as study subjects and were divided into vaginal hysterectomy according to the surgical procedure.According to different operation methods,20 cases were divided into vaginal hysterectomy(vaginal group),laparoscopic hysterectomy(endoscopic group)and transabdominal hysterectomy(transabdominal group).The changes of E 2,FSH,LH,ovarian function score and general sexual function score were compared before and 6 months after treatment.The incidence of perimenopausal symptoms and sexual life disorder was statistically analyzed.Results:The operation time,blood loss,anus exhaust time,length of hospital stay and total cost of the vaginal group were significantly less than those of the abdominal group.The amount of blood loss,hospitalization time and total cost were significantly less than those of the other two groups,and the differences were statistically significant.(P<0.05);E 2 levels in the three groups decreased significantly compared with those before treatment,while FSH and LH levels increased significantly.There was a significant difference in E 2,FSH,and LH levels between the three groups(P<0.05).After treatment,the ovarian function scores of all three groups were increased,and the overall sexual function scores were decreased.The total sexual function scores of the vaginal and endoscopic groups were significantly higher than that of the abdominal group(P<0.05).There was no significant difference in the incidence of perimenopausal symptoms and sexual dysfunction after treatment between the three groups(P>0.05).Conclusions:The three types of hysterectomy all have negative effects on the ovarian function of patients.Vaginal hysterectomy has good clinical effect on patients and has little effect on the ovarian function of patients.Worth promotion.