宫腔镜子宫肌瘤电切术治疗子宫粘膜下肌瘤对患者卵巢储备功能及性功能的影响

Influence of hysteroscopic hysteromyoma electromyectomy on the ovarian reserve function and sexual function in patients with submucous myoma

目的探讨宫腔镜子宫肌瘤电切术治疗子宫粘膜下肌瘤对患者卵巢储备功能及性功能的影响。方法选取2015年1月至2017年5月十堰市妇幼保健院诊治的170例子宫粘膜下肌瘤患者作为研究对象。按随机数字表法将其分为研究组与对照组,每组各85例。对照组患者采用腹腔镜下子宫肌瘤剜除术治疗,研究组采用宫腔镜子宫肌瘤电切术治疗,术后3个月时比较两组患者手术相关指标、卵巢储备功能及性功能改变情况。结果研究组手术时间、术中出血量及术后镇痛率高于对照组,但差异无统计学意义(P>0.05)。研究组术后排气时间及出院时间较对照组短,差异具有统计学意义(P<0.05)。术前两组患者卵巢储备功能指标比较差异无统计学意义(P>0.05)。术后研究组患者FSH、LH、AFC及E2均低于对照组,但差异无统计学意义(P>0.05)。两组患者卵巢储备功能术前与术后比较差异无统计学意义(P>0.05)。两组患者性功能指标术前与术后比较差异无统计学意义(P>0.05)。术前及术后两组患者性欲望、性唤起、阴道润滑、性高潮、性交疼痛及性生活满意度比较差异均无统计学意义(均P>0.05)。结论宫腔镜子宫肌瘤电切术与腹腔镜下子宫肌瘤剜除术对子宫粘膜下肌瘤患者卵巢储备功能及性功能均无明显影响,但宫腔镜子宫肌瘤电切术造成的创伤较小,术后恢复快。

Objective To investigate the influence of hysteroscopic hysteromyoma electromyectomy on the ovarian reserve function and sexual function in patients with submucous myoma. Methods 170 patients with submucous myoma were selected and randomly divided into control group and research group, each of 85 cases.The control group was treated with laparoscopic myomectomy, and research group were treated with hysteroscopic hysteromyoma electromyectomy. The operation related indexes, ovarian reserve function and the changes in sexual function between the two groups at 3 months after the operation were compared. Results The time of operation, amount of intraoperative blood loss and postoperative analgesia in research group were longer and higher than these in control group, but the difference was not statistically significant(P>0.05). The exhaust time and discharge time of research group was shorter than that of the control group, with statistically significant differences(P<0.05). There was no statistically significant difference in the index of ovarian reserve function between the two groups before operation(P>0.05). After the operation, the levels of FSH, LH, AFC and E2 in research group were lower than those in control group, but the difference was not statistically significant(P>0.05). There was no statistically significant difference in preoperative ovarian reserve function and postoperative ovarian reserve function between the two groups(P>0.05). There was no significant difference in preoperative and postoperative sexual function indexes between the two groups(P>0.05). There was no significant difference in the sexual desire, sexual arousal, vaginal lubrication, orgasm, sexual intercourse pain and sexual life satisfaction between the two groups before and after operation(all P>0.05). Conclusions Both hysteroscopic hysteromyoma electromyectomy and laparoscopic myomectomy has little influence on the ovarian reserve function and sexual function in patients with submucous myoma, but hysteroscopic hysteromyoma electromyectomy has smaller trauma with faster recovery time after operation.