两种不同术式治疗子宫肌瘤患者的效果分析

Analysis of the effect of two different Surgical methods on Patients with uterine Fibroids

目的探究两种不同术式治疗子宫肌瘤患者的临床效果。方法选取60例子宫肌瘤患者,根据手术方式不同将其分为腹腔镜组(35例)与经腹组(25例)。经腹组患者采用经腹子宫肌瘤切除术治疗,腹腔镜组患者采用腹腔镜子宫肌瘤切除术治疗。对比两组患者围手术期指标、性激素水平、卵泡数量、卵巢体积、术后妊娠率及流产率。结果腹腔镜组术中出血量明显少于经腹组,首次排气时间、首次下床时间及住院时间均明显短于经腹组,差异有统计学意义(P<0.05).手术前,两组促黄体生成素(LH)、卵泡刺激素(FSH)、孕酮(P)、雌二醇(E_(2))水平对比,差异无统计学意义(P>0.05);手术后,腹腔镜组LH、FSHZK平显著低于经腹组,E_(2),P水平显著高于经腹组,差异有统计学意义(P<0.05)。手术前后两组患者卵泡数量、卵巢体积对比,差异无统计学意义(P>0.05).腹腔镜组术后妊娠率、流产率分别为65.71%、8.57%,经腹组术后妊娠率、流产率分别为64.00%、16.00%,对比差异无统计学意义(P>0.05)。结论腹腔镜子宫肌瘤切除术治疗子宫肌瘤患者具有术中出血量少、术后恢复快、住院时间短等优势,且对性激素水平影响较小,不良妊娠结局相对较少,值得临床推广与应用。

Objective To explore the clinical efiects of two different surgical methods in the treatment of uterine fibroids.Methods 60 patients with uterine fibroids were selected and divided into laparoscopic group(35 cases)and trans abdominal group(25 cases)according to different surgical methods.Patients in the transabdominal group were treated with transabdominal myomectomy,and patients in the laparoscopic group were treated with laparoscopic myomectomy.Perioperative indicators,sex hormone levels,follicular number,ovarian volume,postoperative pregnancy rate and abortion rate were compared between the two groups.Results The amount of intraoperative blood loss in the laparoscopic group was significantly less than that in the transabdominal group,and the time of first exhaust,first time to get out of bed and hospital stay were significantly shorter than that in the transabdominal group,with statistical significance(P<0.05).Before surgeiy,there was no significant difference in the levels of luteinizing hormone(LH),follicle stimulating hormone(FSH),progesterone(P)and estradiol(E_(2))between 2 groups(P>0.05).After surgery,the levels of LH and FSH in the laparoscopic group were significantly lower than those in the transabdominal group,while the levels of E_(2) and P were significantly higher than those in the transabdominal group,with statistical significance(P<0.05).There were no significant difierences in follicle number and ovarian volume between 2 groups before and after operation(P>0.05).The pregnancy rate and abortion rate were 65.71%and 8.57%in the laparoscopic group,and 64.00%and 16.00%in the transabdominal group,respectively,with no statistical significance(P>0.05).Conclusion Laparoscopic hysteromyomectomy for patients with hysteromyoma has the advantages of less intraoperative bleeding,quick postoperative recovery,short hospital stay,and less influence on hormone levels,relatively better pregnancy outcomes,worthy of clinical promotion and application.