腹腔镜下子宫肌瘤切除术治疗肌壁间子宫肌瘤的临床效果分析

Clinical Effect Analysis of Laparoscopic Myomectomy in Treatment of Intramural Hysteromyoma

目的:分析肌壁间子宫肌瘤患者采用腹腔镜下子宫肌瘤切除术治疗的效果。方法:将2019年6月—2022年5月徐州市丰县人民医院收治的72例肌壁间子宫肌瘤患者作为观察对象,根据随机数字表分为对照组(36例,经腹子宫肌瘤切除术治疗),观察组(36例,腹腔镜下子宫肌瘤切除术治疗)。比较两组围术期指标、卵巢功能、应激指标、疼痛程度及并发症发生情况。结果:观察组术中出血量为(80.26±5.61)mL,少于对照组;住院时间为(3.75±0.85)d,短于对照组;手术时间为(70.15±9.32)min,长于对照组,对比有统计学差异(P<0.001)。术前,两组黄体生成素(LH)、促卵泡激素(FSH)、雌二醇(E_(2))水平对比无统计学差异(P>0.05)。术后,两组LH、FSH水平对比无统计学差异(P>0.05);观察组E_(2)水平高于对照组,对比有统计学差异(P<0.05)。两组术前去甲肾上腺素(NE)、肾上腺素(E)、谷胱甘肽过氧化物酶(GSH-Px)水平及术后2 h疼痛评分对比无统计学差异(P>0.05);术后,观察组NE、E水平,疼痛评分较对照组更低,GSH-Px水平较对照组更高,对比有统计学差异(P<0.05)。观察组并发症发生率为2.78%,对照组并发症发生率为11.11%,两组对比无统计学差异(P>0.05)。结论:肌壁间子宫肌瘤患者采用腹腔镜下子宫肌瘤切除术治疗的临床效果显著,可减少术中出血量,缩短住院时间,减少对卵巢功能的影响,减轻应激反应及疼痛,且安全性高。

Objective:To analyze the effect of laparoscopic myomectomy treatment in patients with intramural hysteromyoma.Methods:A total of 72 patients with intramural hysteromyoma treated in Fengxian People′s Hospital of Xuzhou City from June 2019 to May 2022 were collected as the observation subjects.They were divided into control group(36 cases,transabdominal myomectomy)and observation group(36 cases,laparoscopic myomectomy)according to random number table method.Perioperative indexes,ovarian function,stress indicators,pain degree and complications were compared between the two groups.Results:The intraoperative blood loss in the observation group was(80.26±5.61)mL,which was less than that in the control group;The hospitalization time in the observation group was(3.75±0.85)d,which was shorter than that in the control group;The operation time in the observation group was(70.15±9.32)min,which was longer than the control group,and the difference was statistically significant(P<0.001).Before operation,there were no significant differences in luteinizing hormone(LH),folliclestimulating hormone(FSH)and estradiol(E_(2))levels between the two groups(P>0.05).After operation,there were no significant differences in LH and FSH levels between the two groups(P>0.05);the E_(2) level in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before operation,there were no significant differences in norepinephrine(NE),epinephrine(E),glutathione peroxidase(GSH-Px)levels and pain score at postoperative 2 h between two groups(P>0.05).After operation,the NE and E levels and pain score in the observation group were lower than those in the control group,the level of GSH-Px in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The incidence of complications was 2.78%in the observation group and 11.11%in the control group,with no significant difference between two groups(P>0.05).Conclusion:Laparoscopic myomectomy treatment in patients with intramural hysteromyoma has significant clinical effects,and can reduce intraoperative blood loss,shorten hospital stay,reduce the impact on ovarian function,relieve stress reaction and pain,and has high safety.