宫腔镜电切术治疗黏膜下子宫肌瘤的临床效果及对患者性激素水平、卵巢储备功能的影响

Clinical effect of hysteroscopic electric resection in the treatment of submucosal uterine fibroids and its influences on sex hormone levels and ovarian reserve function of patients

目的探究宫腔镜电切术治疗黏膜下子宫肌瘤的临床效果及对患者性激素水平、卵巢储备功能的影响。方法选取2018年1月至2020年6月本院收治的88例黏膜下子宫肌瘤患者为研究对象,遵循随机数字表法将其分为参照组(n=44)、研究组(n=44)。参照组开展腹腔镜子宫肌瘤剔除术,研究组开展宫腔镜电切术。比较两组的治疗效果。结果研究组的术后排气时间、首次下床时间、住院时间、月经恢复时间均短于参照组(P<0.05)。术后1 d,研究组的白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平低于参照组(P<0.05)。术后3个月,两组的黄体生成素(LH)、卵泡刺激素(FSH)、孕酮(P)水平及阻力指数(RI)、搏动指数(PI)、窦卵泡数(AFC)均升高,雌二醇(E2)水平及卵巢间质动脉的收缩期峰值(PSV)均降低,且研究组优于参照组(P<0.05)。研究组的术后并发症总发生率低于参照组(P<0.05)。研究组术后1、2、3、7 d的视觉模拟评分法(VAS)评分低于参照组(P<0.05)。结论宫腔镜电切术治疗黏膜下子宫肌瘤可缩短术后康复时间,改善患者的性激素、卵巢储备功能、炎性因子指标水平,降低术后并发症发生率,减轻术后疼痛感,有积极的临床应用价值。

Objective To explore the clinical effect of hysteroscopic electric resection in the treatment of submucosal uterine fibroids and its influences on sex hormone levels and ovarian reserve function of patients.Methods A total of 88 patients with submucosal uterine fibroids admitted in our hospital from January 2018 to June 2020 were selected as the study objects.The patients were divided into reference group(n=44)and study group(n=44)according to the random number table method.The reference group received laparoscopic myomectomy,and the study group received hysteroscopic electric resection.The therapeutic effects of the two groups were compared.Results The postoperative exhaust time,first ambulation time,hospitalizat stay and menstrual recovery time of the study group were shorter than those of the reference group(P<0.05).One day after operation,the levels of interleukin-6(IL-6),high-sensitivity C-reactive protein(hs-CRP)and tumor necrosis factor-α(TNF-α)in the study group were lower than those in the reference group(P<0.05).Three months after operation,the luteinizing hormone(LH),follicle stimulating hormone(FSH),progesterone(P)levels and resistance index(RI),pulsatility index(PI),and antral follicle count(AFC)in the two groups increased,while the estradiol(E2)level and peak systolic velocity(PSV)of ovarian interstitial artery decreased,and those in the study group were better than the reference group(P<0.05).The total incidence of postoperative complications in the study group was lower than that in the reference group(P<0.05).The visual analogue scale(VAS)scores at 1,2,3 and 7 d after operation of the study group were lower than those of the reference group(P<0.05).Conclusion Hysteroscopic electric resection for submucosal uterine fibroids can shorten the postoperative rehabilitation time,improve the levels of sex hormones,ovarian reserve function and inflammatory factors,reduce the incidence of postoperative complications and postoperative pain.It has positive clinical value.