腹腔镜全子宫切除治疗子宫腺肌症的临床研究

Clinical Study of Laparoscopic Total Hysterectomy in the Treatment of Adenomyosis

目的探讨腹腔镜全子宫切除治疗子宫腺肌症的临床价值。方法选取2016年1月—2020年1月于该院接受治疗的51例子宫腺肌症患者,依据抽签法分为对照组(n=23)与观察组(n=28)。对照组行传统开腹全子宫切除术治疗,观察组行腹腔镜全子宫切除治疗,比较两组手术相关指标、性激素水平及并发症发生情况。结果观察组手术操作时间、术中失血量、排气时间及总住院时间均低于对照组,差异有统计学意义(t=4.522、18.872、6.567、9.802,P<0.001);术后14 d,两组促黄体生成激素(LH)、卵泡刺激素(FSH)水平均低于术前,雌二醇(E2)水平高于术前,且观察组优于对照组,差异有统计学意义(t=7.062、6.562、7.961,P<0.001);观察组并发症发生率(7.14%)略低于对照组(13.04%),但差异无统计学意义(χ^(2)=0.054,P>0.05)。结论子宫腺肌症患者采用腹腔镜全子宫切除治疗效果显著,可有效缩短手术操作时间,降低手术失血量,可有效改善患者机体性激素水平,且并发症略低,有利于促进患者身体转归,值得临床广泛推广。

Objective To explore the clinical value of laparoscopic total hysterectomy in the treatment of adenomyosis.Methods A total of 51 patients with adenomyosis who were treated in the hospital from January 2016 to January 2020 were selected and divided into a control group(n=23)and an observation group(n=28)according to the lottery method.The control group underwent traditional open hysterectomy,and the observation group underwent laparoscopic total hysterectomy.The two groups were compared with related surgical indicators,sex hormone levels and complications.Results Operation time,intraoperative blood loss,exhaust time and total hospital stay in the observation group were all lower than those in the control group,the differences were statistically significant(t=4.522,18.872,6.567,9.802,P<0.001).On day 14 after surgery,the levels of luteinizing hormone(LH)and follicle stimulating hormone(FSH)in both groups were lower than those before surgery,and the levels of estradiol(E2)in both groups were higher than those before surgery,and the observation group was better than the control group,the difference was statistically significant(t=7.062,6.562,7.961,P<0.001).The incidence of complications in the observation group(7.14%)was slightly lower than that in the control group(13.04%),but the difference was not statistically significant(χ^(2)=0.054,P>0.05).Conclusion Laparoscopic total hysterectomy in patients with adenomyosis has a significant effect,which can effectively shorten the operation time,reduce the amount of blood loss,and can effectively improve the patient's body sex hormone level,and the complications are slightly lower,which is beneficial to promote the patient's physical outcome.It is worthy of widespread clinical promotion.