腹腔镜下子宫动脉上行支阻断辅助子宫肌瘤剔除术治疗子宫肌瘤的疗效及对患者性激素水平的影响

Effect of Laparoscopic Upper branch of uterine artery Occlusion assisted Myomectomy in the Treatment of uterine fibroids and its effect on sex Hormone levels in patients

目的探讨腹腔镜下子宫动脉上行支阻断辅助子宫肌瘤剔除术治疗子宫肌瘤患者的临床疗效及对性激素水平的影响。方法选取66例子宫肌瘤患者,按照随机数字表法分为对照组与研究组,各33例。对照组采用腹腔镜下子宫剔除术,研究组采用腹腔镜下子宫动脉上行支阻断辅助子宫肌瘤剔除术,比较两组患者手术情况、治疗前后性激素水平、术后第1次月经时间、月经稀发延迟发生率及复发率。结果研究组术中出血量明显少于对照组,差异有统计学意义(P<0.05),而两组手术时间、术后排气时间以及住院时间比较,差异无统计学意义(P>0.05)。治疗前,两组患者卵泡刺激素、雌二醇水平比较,差异无统计学意义(P>0.05);治疗后3个月,两组患者卵泡刺激素水平均有所升高,雌二醇水平均有所下降,但组间比较差异无统计学意义(P>0.05),治疗后6个月,两组患者卵泡刺激素、雌二醇水平均恢复至治疗前水平,组间比较差异无统计学意义(P>0.05)。研究组术后第1次月经时间(32.29±5.46)d明显早于对照组(37.96±6.18)d,且术后6个月复发率为3.03%低于对照组27.27%,差异有统计学意义(P<0.05);两组月经稀发延迟发生率比较差异无统计学意义(P>0.05)。结论腹腔镜下子宫动脉上行支阻断辅助子宫肌瘤剔除术虽手术时间略长,但术中出血量少,术后月经恢复较快,且对性激素水平影响较小,同时还能降低术后复发率。

Objective To investigate the clinical efficacy of laparoscopic uterine artery ascending branch occlusion assisted myomectomy in the treatment of uterine fibroids and its effect on the level of sex honnones.Methods 66 cases of uterine fibroids were selected and divided into control group and study group according to random number table,33 cases in each group.The control group received laparoscopic hysterectomy,while the study group received laparoscopic uterine artery ascending branch occlusion assisted hysteromyomectomy.The operation conditions,the level of sex hormones before and after treatment,the time of the first menstruation after surgery,the incidence of delayed menstruation and the recurrence rate of the two groups were compared.Results The intraoperative blood loss in the study group was significantly less than that in the control group,and the difference was statistically significant(P<0.05),while there was no significant difference in the operative time,postoperative exhaust time and hospital stay between the two groups(P>0.05).Before treatment,there was no significant difference in the levels of FSH and estradiol between 2 groups(P>0.05).3 months after treatment,two groups of follicle-stimulating hormone levels of patients was increased,the level of estradiol was decreased,but the comparative differences between groups have no statistical significance(P>0.05),and 6 months after treatment,two groups of patients follicle-stimulating hormone,estradiol levels are restored to the level before treatment,compare the differences between groups have no statistical significance(P>0.05).The first menstrual period in the study group was(32.29±5.46)d earlier than that in the control group(37.96±6.18)d,and the recurrence rate at 6 months after operation was 3.03%lower than that in the control group(27.27%),with statistical significance(P<0.05).There was no significant difference in the incidence of delayed menstruation between the two groups(P>0.05).Conclusion Although the operation time of uterine myomectomy assisted by uterine artery ascending branch occlusion is slightly longer,the intraoperative blood loss is less,the postoperative menstrual recovery is faster,and the influence on the level of sex hormones is less,and the postoperative recurrence rate can be reduced.