腹腔镜全子宫切除术并切除双侧输卵管治疗妇科良性疾病育龄患者的效果

Effect of Laparoscopic Total Hysterectomy and Removal of Bilateral Fallopian Tubes in the Treatment of Childbearing Age Patients with Gynecological Benign Diseases

目的:研究腹腔镜全子宫切除术同时切除双侧输卵管治疗妇科良性疾病育龄女性患者的效果及对雌二醇(E_(2))、黄体生成素(LH)、血清卵泡刺激素(FSH)及抗苗勒氏管激素(AMH)水平的影响。方法:选择2018年3月-2020年3月就诊于本院妇产科的82例妇科良性疾病育龄女性患者为研究对象,按随机数字表法划分为试验组(n=41)与对照组(n=41)。对照组行腹腔镜全子宫切除术治疗,试验组行腹腔镜全子宫切除术同时切除双侧输卵管治疗。比较两组围手术期情况、手术前后E_(2)、LH、FSH、AMH水平、围绝经期症状及术后并发症。结果:两组手术前后E_(2)、LH、FSH、AMH水平对比差异均无统计学意义(P>0.05)。术后两组LH、FSH水平均较术前上升,E_(2)、AMH水平、Kupperman评分均较术前下降,差异有统计学意义(P<0.05);试验组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:腹腔镜全子宫切除术同时切除双侧输卵管治疗有助于减少妇科良性疾病育龄女性患者术后并发症发生,并且不会过多影响到卵巢正常功能,对于术后预防卵巢癌发生风险具有积极作用。

Objective:To study the effect of laparoscopic total hysterectomy and removal of bilateral fallopian tubes in the treatment of gynecological benign diseases in women of childbearing age and its influence on estradiol (E_(2)),luteinizing hormone (LH),serum follicle stimulating hormone (FSH) and anti-Müllerian hormone (AMH) levels.Method:A total of 82 female patients of childbearing age with gynecological benign diseases who were treated in the department of obstetrics and gynecology in our hospital from March 2018 to March 2020 were selected as the research objects.They were divided into the experimental group (n=41) and the control group (n=41).The control group underwent laparoscopic total hysterectomy treatment,and the experimental group underwent laparoscopic total hysterectomy with removal of bilateral fallopian tubes treatment.The perioperative conditions,E_(2),LH,FSH,AMH levels,perimenopausal symptoms and postoperative complications of the two groups were compared and analyzed.Result:There was no significant difference in the levels of E_(2),LH,FSH,AMH between the two groups before and after surgery (P>0.05).The levels of LH and FSH in the two groups after operation increased than those before operation,the levels of E_(2),AMH and Kupperman score decreased than those before operation,and the differences were statistically significant (P<0.05).The incidence of postoperative complications of the experimental group was lower than that of the control,the difference was statistically significant (P<0.05).Conclusion:Laparoscopic total hysterectomy with removal of bilateral fallopian tubes can help reduce postoperative complications in female patients of childbearing age with gynecological benign diseases,and will not affect the normal function of the ovary too much,which has a positive effect on the risk of ovarian cancer prevention after surgery.