阴式子宫切除术与腹腔镜下子宫切除术对子宫肌瘤患者卵巢功能的影响

Influence of vaginal hysterectomy and laparoscopic hysterectomy on ovarian function in patients with uterine fibroids

目的探究阴式子宫切除术(TVH)与腹腔镜下子宫切除术(TLH)对子宫肌瘤患者卵巢功能的影响。方法选取2017年11月至2019年12月本院收治的子宫肌瘤患者88例,根据随机数字表法分为阴式组和腹腔镜组,每组44例。阴式组行TVH治疗,腹腔镜组行TLH治疗。比较两组手术相关指标、卵巢功能及性功能。结果阴式组术后镇痛、手术时间比较差异无统计学意义。阴式组术后住院时间、肛门排气时间均短于腹腔镜组,术中出血量少于腹腔镜组,差异有统计学意义(P<0.05)。术前,两组卵巢功能、性功能评分比较差异无统计学意义;术后,两组LH、FSH、E_(2)、性功能评分比较差异无统计学意义,且组间比较差异无统计学意义。结论TVH与TLH治疗子宫肌瘤均会对患者性功能造成一定负面影响,对卵巢功能无明显影响,但阴式手术能减少术中出血量,缩短住院时间,临床可根据患者病情选择适宜手术方式。

Objective To explore the effects of vaginal hysterectomy(TVH)and laparoscopic hysterectomy(TLH)on ovarian function in patients with uterine fibroids.Methods 88 patients with uterine fibroids admitted to our hospital from November 2017 to December 2019 were selected and divided into vaginal group and laparoscopic group according to the random number table method,with 44 cases in each group.The vaginal group received TVH treatment,and the laparoscopic group received TLH treatment.The surgical related indexes,ovarian function and sexual function between the two groups were compared.Results There was no significant difference in postoperative analgesia and operation time beteen two group.The postoperative hospital stay and anal exhaust time of the vaginal group were shorter than those of the laparoscopic group,and the intraoperative blood loss was less than that of the laparoscopic group,the difference was statistically significant(P<0.05).Before surgery,there was no statistically significant difference in ovarian function and sexual function scores between the two groups;after surgery,there was no statistically significant difference in LH,FSH,E_(2),and sexual function scores between the two groups,and there was no statistically significant difference between the two groups.Conclusion Both TVH and TLH treatment of uterine fibroids will have certain negative impact on the patient's sexual function,and have no significant impact on ovarian function.However,vaginal surgery can reduce intraoperative blood loss and shorten the length of hospitalization.Clinically,the appropriate surgical method can be selected according to the patient's condition.