腹腔镜下子宫肌瘤剔除术的临床疗效及其对病人激素指标和炎性因子水平影响

Clinical efficacy of laparoscopic myomectomy and its influence on hormone index and inflammatory factor level

目的:探讨腹腔镜下子宫肌瘤剔除术的临床疗效和对病人激素指标、炎性因子水平的影响。方法:选取子宫肌瘤病人720例,按随机数表法分为对照组和观察组,各360例。对照组行传统开腹手术治疗,观察组行腹腔镜下子宫肌瘤剔除术治疗。比较2组手术指标和手术前后的应激激素水平、卵巢功能指标和炎性因子水平。结果:观察组病人手术时间、术中出血量、肛门排气时间、VAS评分及住院时间等手术指标均明显优于对照组(P<0.01)。术前2组肿瘤坏死因子α、C反应蛋白、皮质醇、去甲肾上腺素、促黄体生成激素、促卵泡生成激素、雌二醇水平差异均无统计学意义(P>0.05);术后2组肿瘤坏死因子α、C反应蛋白、皮质醇、去甲肾上腺素、促黄体生成激素、促卵泡生成激水平均较术前明显升高,且观察组均明显低于对照组(P<0.01),而2组雌二醇水平均较术前明显降低,且观察组明显高于对照组(P<0.01)。结论:腹腔镜下子宫肌瘤剔除术临床疗效较好,能有效减轻病人炎症及应激反应,缓解机体免疫抑制,减轻血清创伤反应,改善卵巢功能,具有较高的临床价值。

Objective:To investigate the clinical efficacy of laparoscopic myomectomy and its influence on hormone index and inflammatory factor level.Methods:Seven hundred and twenty patients with uterine myoma were randomly divided into the control group and observation group(360 cases in each group).The control group was treated with traditional laparotomy,and the observation group was treated with laparoscopic myomectomy.The levels of inflammatory factors,stress hormones and ovarian function indexes before and after treatment were compared between two groups.Results:The operative time,intraoperative blood loss,anal exhaust time,VAS score and length of hospital stay in observation group were significantly better than those in control group(P<0.01).There was no statistical significance in the levels of TNF-α,CRP,COR,NE,LH,FSH,E2 between two groups before operation(P>0.05).The levels of TNF-α,CRP,COR,NE,LH and FSH in two groups after operation significantly increased with compared which before operation,and which in observation group were lower than those in control group(P<0.01).The levels of E2 in two groups after operation significantly decreased compared with before operation,and which in observation group was significantly higher than that in control group(P<0.01).Conclusions:The clinical efficacy of laparoscopic myomectomy is good,which can effectively reduce inflammation and stress reaction,alleviate immunosuppression,reduce serum trauma reaction and improve ovarian function.