腹腔镜次全子宫切除术对子宫多发肌瘤患者远期生活质量的影响

Effect of Laparoscopic Subtotal Hysterectomy on Long-term Quality of Life in Patients with Multiple Uterine Fibroids

目的:研究腹腔镜次全子宫切除术对子宫多发肌瘤患者远期生活质量的影响。方法:选择2015年1月-2019年1月黄冈市中心医院收治的180例子宫多发肌瘤患者作为研究对象,采用随机数字表法分为观察组(n=90)和对照组(n=90)。观察组采用腹腔镜次全子宫切除术治疗,对照组采用腹腔镜全子宫切除术治疗。比较两组围手术期指标、卵巢功能、生活质量及性功能生活质量差异。结果:观察组手术持续时间、肛门排气时间、整体住院时间均短于对照组,术中出血量低于对照组,差异均有统计学意义(P<0.05);术后1年,观察组雌二醇(E)水平、卵巢体积、窦卵泡数量优于对照组,促卵泡激素(FSH)、促黄体生成素(LH)水平低于对照组,差异均有统计学意义(P<0.05);术后1年,观察组生活质量评分(QOL)、女性性功能指数调查量表(FSFI)评分高于对照组,差异有统计学意义(P<0.05)。结论:与腹腔镜全子宫切除术相比,腹腔镜次全子宫切除术能有效缩短子宫多发肌瘤患者手术时间与住院时间,患者术后卵巢功能损伤更小,远期生活质量与性生活质量更好,具有推广价值。

Objective:To study the effect of laparoscopic subtotal hysterectomy on the long-term quality of life in patients with multiple uterine fibroids.Method:A total of 180 patients with multiple uterine fibroids treated in Huanggang Central Hospital from January 2015 to January 2019 were selected as the research object.According to the method of random number table,they were divided into observation group (n=90) and control group (n=90).The observation group was treated with laparoscopic subtotal hysterectomy,and the control group was treated with laparoscopic total hysterectomy.The perioperative indexes,ovarian function,quality of life and sexual function were compared between the two groups.Result:The operation duration,anal exhaust time,overall hospital stay in the observation group were shoter than those in the control group,and intraoperative blood output in the observation group was significantly lower than that in the control group,the differences were statistically significant (P<0.05).One year after operation,the level of estradiol (E),ovarian volume and the number of sinus follicles in the observation group were better than those in the control group,and the levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) were lower than those in the control group,the differences were statistically significant (P<0.05).One year after operation,the quality of life (QOL) and female sexual function index (FSFI) scores in the observation group were significantly higher than those in the control group,the differences were statistically significant (P<0.05).Conclusion:Compared with laparoscopic total hysterectomy,laparoscopic subtotal hysterectomy can effectively shorten the operation time and hospital stay of patients with multiple hysteromyoma,reduce the postoperative ovarian function injury,and have better long-term quality of life and sexual life.It has popularization value.