微波消融、腹腔镜手术治疗子宫肌瘤的临床效果比较

Comparison of Clinical Effects of Microwave Ablation and Laparoscopic Surgery on Uterine Leiomyoma

目的比较微波消融、腹腔镜手术治疗子宫肌瘤的临床效果。方法选取吉林市中心医院2018年2月至2019年5月接受治疗的子宫肌瘤患者90例,按随机数字表法将其分为超声消融组(n=45)和腹腔镜手术组(n=45)。腹腔镜手术组采用腹腔镜下子宫肌瘤切除术治疗。超声消融组则采用超声消融治疗。观察比较2组患者的治疗效果,对比2组患者雌二醇(E2)、黄体生成素(FSH)、促黄体生成素(LH)等卵巢功能指标的变化情况,并记录2组患者在术中输血,麻醉相关并发症,治疗后2 d内发热、疼痛、非计划再入院等事件的发生比例,统计其住院时间。结果超声消融组、腹腔镜手术组治疗的有效率分别为91.11%、95.56%,组间比较差异无统计学意义(P>0.05)。2组患者治疗前的E2、FSH、LH指标相比差异无统计学意义(P>0.05),治疗后3个月,2组患者E2高于治疗前(P>0.05)、FSH则低于治疗前(P>0.05)、LH指标无明显变化(P>0.05)。2组患者治疗后3个月的E2、FSH、LH指标比较,差异无统计学意义(P>0.05)。超声消融组的术后的麻醉并发症比例、输血比例均少于腹腔镜手术组,组间差异有统计学意义(P<0.05);2组患者治疗后2d内发热、疼痛以及非计划再入院相比,组间差异无统计学意义(P>0.05);住院时间短于腹腔镜手术组,差异有统计学意义(P<0.05)。结论超声消融治疗子宫肌瘤的效果与腹腔镜手术相当,但其治疗临床并发症较少,患者身体恢复较快。

Objective To compare the clinical effect of microwave ablation and laparoscopic surgery on uterine leiomyoma.Methods From February 2018 to May 2019,Totally 90 cases of uterine leiomyoma treated in Jilin Central Hospital were selected.They were divided into ultrasonic ablation group(n=45)and laparoscopic surgery group(n=45)according to random digital table.The laparoscopic operation group was treated with laparoscopic hysterectomy.The ultrasound ablation group was treated with ultrasound ablation.The therapeutic effect of the two groups of patients was observed and compared,the changes of ovarian function such as estradiol(E2),luteinizing hormone(FSH)and luteinizing hormone(LH)in the two groups were compared.And the incidence of blood transfusion,anaesthesia-related complications,fever,pain,unplanned readmission and other events in the two groups during the operation were recorded,and their hospitalization time was counted.Results The effective rates of ultrasound ablation group and laparoscopic surgery group were 91.11%and 95.56%,respectively,with no statistically significant difference(P>0.05).There was no significant difference in E2,FSH and LH indexes between the two groups before treatment(P>0.05),and 3 months after treatment,E2 was higher than before treatment(P>0.05),FSH was lower than before treatment(P>0.05),and LH indexes had no significant change(P>0.05).There was no significant difference in E2,FSH and LH between the two groups 3 months after treatment(P>0.05).The proportion of postoperative anesthesia complications and blood transfusion in the ultrasound ablation group was lower than that in the laparoscopic surgery group,and the difference between the groups was statistically significant(P<0.05).There was no statistically significant difference between the two groups in terms of fever,pain and unplanned readmission within 2 d after treatment(P>0.05).The length of hospital stay was shorter than that of the laparoscopic surgery group,and the difference was statistically significant(P<0.05).Conclusions The effect of ultrasound ablation in the treatment of uterine leiomyoma is comparable to that of laparoscopic surgery,but its treatment of clinical complications is less,and the patient's body recovery is faster,which is worthy of further clinical study.