腹腔镜与宫腔镜手术治疗子宫肌瘤的疗效及对患者卵巢功能的影响分析

Effect analysis of laparoscopy and hysteroscopy in the treatment of hysteromyoma and its influence on ovarian function

目的分析腹腔镜与宫腔镜手术治疗子宫肌瘤的疗效及对患者卵巢功能的影响。方法100例子宫肌瘤患者,采用随机数字表法分为对照组和观察组,每组50例。对照组患者给予腹腔镜手术治疗,观察组实施宫腔镜手术治疗。比较两组患者手术时间、手术失血总量,治疗前后激素(黄体生成素、雌二醇、促卵泡生成素)水平,中转开腹率、切口感染发生率、术后6个月肌层完全愈合率。结果治疗前,两组黄体生成素、雌二醇、促卵泡生成素水平比较差异无统计学意义(P>0.05);治疗后,两组黄体生成素、雌二醇、促卵泡生成素水平均较治疗前降低,且观察组降低幅度小于对照组,差异有统计学意义(P<0.05)。观察组手术时间(41.21±3.21)min短于对照组的(77.12±12.45)min,手术失血总量(24.15±2.21)ml少于对照组的(146.21±12.24)ml,差异有统计学意义(P<0.05)。观察组术后6个月肌层完全愈合率90.00%(45/50)高于对照组的70.00%(35/50),差异有统计学意义(P<0.05)。两组中转开腹率、切口感染发生率比较差异无统计学意义(P>0.05)。结论对子宫肌瘤患者实施宫腔镜手术治疗的效果确切,与腹腔镜手术比较,对卵巢功能的影响更小,术中出血少,手术时间短,且可加速肌层愈合。

Objective To analyze the efficacyof laparoscopy and hysteroscopy in the treatment of hysteromyoma and its influence on ovarian function.Methods A total of 100 patients with hysteromyoma were divided into control group and observation group according to random numerical table,with 50 cases in each group.The control group was treated with laparoscopic surgery,and the observation group was treated with hysteroscopic surgery.The operation time,total blood loss,levels of hormones(luteinizing hormone,estradiol and follicle stimulating hormone)before and after treatment,rate of conversion to laparotomy,incidence of incision infection and complete healing rate of muscle layer 6 months after operation were compared between the two groups.Results Before treatment,there was no statistically significant difference in the levels of luteinizing hormone,estradiol,and follicle stimulating hormone between the two groups(P>0.05).After treatment,the levels of luteinizing hormone,estradiol,and follicle stimulating hormone in the two groups were lower than those before treatment,and the reduction in the observation group was less than that in the control group.All the difference was statistically significant(P<0.05).The operation time(41.21±3.21)min of the observation group was shorter than(77.12±12.45)min of the control group,and the total blood loss(24.15±2.21)ml was less than(146.21±12.24)ml of the control group.All the difference was statistically significant(P<0.05).The complete healing rate of muscle layer 6 months after operation in the observation group was 90.00%(45/50),which was higher than 70.00%(35/50)of the control group,and the difference was statistically significant(P<0.05).There was no statistically significant difference in the rate of conversion to laparotomy and the incidence of incision infection between the two groups(P>0.05).Conclusion Hysteroscopic surgery has definite effect on patients with hysteromyoma.Compared with laparoscopic surgery,it has less impact on ovarian function,less intraoperative blood loss,shorter operation time,and can accelerate the healing of muscle layer.