腹腔镜下子宫动脉上行支阻断辅助子宫肌瘤剔除术对卵巢功能及性功能的影响

Influence of laparoscopic uterine artery ascending branch blocking assisted hysteromyomectomy on ovarian and sexual function

目的研究腹腔镜下子宫动脉上行支阻断辅助子宫肌瘤剔除术对卵巢功能及性功能的影响。方法回顾性分析2014年1月～2017年1月于我院确诊的60例子宫肌瘤患者的资料,按手术术式不同分为A组和B组,每组各30例。A组行腹腔镜下子宫动脉上行支阻断辅助子宫肌瘤剔除术,B组行腹腔镜子宫全切除术,对患者两种手术术后卵巢功能、性生活质量等指标进行分析。结果 A组患者的术中出血量少于B组,手术时间、术后排气时间及住院时间短于B组(P<0.05);手术治疗6个月后,A组患者的血清促性腺激素(FSH)、黄体生成素(LH)、雌激素(E2)水平与手术前比较,差异无统计学意义(P>0.05); B组患者的FSH、LH较手术前明显升高,E2较手术前明显降低,差异有统计学意义(P<0.05);A组患者术后的FSH、LH低于B组、E2水平高于B组,差异有统计学意义(P<0.05);A组患者术后的性功能评分显著高于B组(P<0.05)。结论腹腔镜下子宫动脉上行支阻断辅助子宫肌瘤剔除术的术中出血量少,术后恢复快,对患者卵巢功能、性功能影响较小,并保留了生育能力,患者生活质量更高,值得在临床上合理运用。

Objective To study the influence of laparoscopic uterine artery ascending branch blocking assisted hysteromyomectomy on ovarian function and sexual function.Methods The data of 60 patients with uterine myoma who were confirmed in our hospital from January 2014 to January 2017 were retrospectively analyzed.All the patients were divided into group A and group B according to the different surgical methods,with 30 cases in each group.Group A underwent laparoscopic uterine artery ascending branch blocking assisted hysteromyomectomy.Group B underwent laparoscopic total hysterectomy(TLH).After two surgical procedures,the ovarian function,sexual life quality and other indicators were analyzed.Results The intraoperative blood loss in group A was less than that in group B,the operation time,postoperative exhaust time and hospitalization time were shorter than those in group B(P<0.05).There were no statistically significant differences in follicle-stimulating hormone(FSH),luteinizing hormone(LH)and estrogen(E2)of group A at post-operational 6 months in contrast with those before operation(P>0.05).FSH and LH levels of group B were significantly higher than those before operation,and E2 of group B was significantly lower than that before operation,with statistically significant difference(P<0.05).After operation the FSH and LH levels in group A were lower than those in group B,E2 levels was higher than that in group B,with statistically significant difference(P<0.05).The sexual function of group A was higher than that of group B(P<0.05).Conclusion Laparoscopic uterine artery ascending branch blocking assisted hysteromyomectomy is featured with less haemorrhage,rapid recovery,less impact on ovarian function and sexual function,and retention of fertility,which enables patients to have higher quality of life,and is worthy of clinically rational use.