超声引导下宫腔镜手术治疗内突型肌壁间子宫肌瘤患者的效果

Effects of ultrasound-guided hysteroscopic surgery in treatment of patients with intramural myoma

目的:观察超声引导下宫腔镜手术治疗内突型肌壁间子宫肌瘤患者的效果。方法:选取2020年6月至2021年12月该院收治的84例内突型肌壁间子宫肌瘤患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各42例。对照组采用常规开腹手术治疗,观察组采用超声引导下宫腔镜手术治疗,比较两组手术相关指标水平、并发症发生率、血清性激素指标[雌二醇(E2)、孕酮(P)、黄体生成素(LH)、卵泡刺激素(FSH)]水平、月经量、复发率、妊娠率和生命质量[简明健康状况调查问卷(SF-36)]评分。结果:观察组住院时间、手术时间、排气时间均短于对照组,术后出血量少于对照组,差异有统计学意义(P<0.05);观察组并发症发生率为4.76%,明显低于对照组的19.05%,差异有统计学意义(P<0.05);术后1个月,两组E2、P水平均低于术前,且观察组低于对照组,两组LH、FSH水平均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05);术后1、3、6个月,两组月经量均少于术前,且观察组少于对照组,差异有统计学意义(P<0.05);术后6个月,两组复发率和妊娠率比较,差异均无统计学意义(P>0.05);术后6、12个月,两组SF-36评分均高于术前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:超声引导下宫腔镜手术治疗内突型肌壁间子宫肌瘤患者可降低手术相关指标水平、月经量和并发症发生率,改善血清性激素指标水平,提高生命质量评分,优于常规开腹手术治疗效果。

Objective:To observe effects of ultrasound-guided hysteroscopic surgery in treatment of patients with intramural myoma.Methods:A prospective study was conducted on 84 patients with intramural myoma admitted to the hospital from June 2020 to December 2021.They were divided into control group and observation group according to the random number table method,42 cases in each group.The control group was treated with conventional open surgery,while the observation group was treated with ultrasound-guided hysteroscopic surgery.The levels of surgeryrelated indicators,the incidence of complications,the serum sex hormone indicator levels[estradiol(E2),progesterone(P),luteinizing hormone(LH),follicle estrogen(FSH)],the menstrual volume,the recurrence rate,the pregnancy rate,and the quality of life[short form health survey(SF-36)]scores were compared between the two groups.Results:The hospitalization time,the operation time and the exhaust time of the observation group were shorter than those of the control group;the postoperative bleeding volume was less than that of the control group;and the differences were statistically significant(P<0.05).The incidence of complications in the observation group was 4.76%,which was significantly lower than 19.05%in the control group,the difference was statistically significant(P<0.05).1 month after the surgery,the levels of E2 and P in the two groups were lower than those before the surgery,and those in the observation group were lower than those in the control group;the levels of LH and FSH in the two groups were higher than those before the surgery,and those in the observation group were higher than those in the control group;and the differences were statistically significant(P<0.05).1,3 and 6 months after the surgery,the menstrual volume levels of the two groups were less than those before the surgery,that of the observation group was less than that of the control group,and the differences were statistically significant(P<0.05).There were no significant differences in the recurrence rate and the pregnancy rate between the two groups 6 months after the surgery(P>0.05).6 and 12 months after the surgery,the SF-36 scores of the two groups were higher than those before the surgery,those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusions:Ultrasound-guided hysteroscopic surgery for the patients with intramural myoma can reduce the levels of surgery-related indicators,the menstrual volume levels and the incidence of complications,improve the levels of serum sex hormone indicators,and improve the quality of life scores.Moreover,it is superior to conventional open surgery.