LM与LAVH对巨大子宫肌瘤患者性功能的影响

Effects of LM and LAVH on Sexual Function of Patients with Huge Leiomyoma Uterus

目的:探究腹腔镜子宫肌瘤剔除术(LM)与腹腔镜辅助阴式全子宫切除术(LAVH)对巨大子宫肌瘤(HLU)患者性功能的影响。方法:选取2019年3月—2022年3月赣南医学院附属兴国医院妇科接诊的125例HLU患者作为研究对象,采用随机数字表法将其分为LM组(61例)和LAVH组(64例)。比较两组手术指标、术后恢复情况、性激素、性功能、免疫指标及术后并发症。结果:LAVH组手术时间、住院时间均短于LM组,下床时间及排气时间均早于LM组,术中出血量少于LM组,差异均有统计学意义(P<0.05)。术后2个月,两组雌二醇(E_(2))、促卵泡激素(FSH)、促黄体生成激素(LH)水平均较术前降低,性功能评分均较术前升高,差异均有统计学意义(P<0.05);术后2个月,两组IgA、Ig G、IgM水平较术前均降低,LAVH组免疫功能指标均高于LM组,差异均有统计学意义(P<0.05)。LAVH组术后并发症总发生率低于LM组,差异有统计学意义(P<0.05)。结论:相比LM,LAVH可减少HLU患者手术创伤及并发症发生率,还可减少对性功能的影响。

Objective:To explore the effects of laparoscopic myomectomy(LM)and laparoscopic assisted vaginal hysterectomy(LAVH)on sexual function in patients with huge leiomyoma uterus(HLU).Method:A total of 125 HLU patients admitted to the Department of Gynecology of Xingguo Hospital Affiliated to Gannan Medical College from March 2019 to March 2022 were selected as research subjects,they were divided into the LM group(61 cases)and the LAVH group(64 cases)by random number table method.The surgical indexes,postoperative recovery,sex hormones,sexual function,immune indexes and postoperative complications were compared between the two groups.Result:The surgery time,hospital stay in the LAVH group were shorter than those in the LM group,time to get out of bed,and time to pass gas were all earlier in the LAVH group than those in the LM group,with the anmount of intraoperative blood loss was less than that in the LAVH group,the differences were statistically significant(P<0.05).Two months after surgery,levels of estradiol(E2),follicle stimulating hormone(FSH),luteinizing hormone(LH)in both groups decreased compared to those before surgery,and sexual function scores were higher than those before surgery,the differences were statistically significant(P<0.05).Two months after surgery,levels of IgA,IgG,IgM in both groups decreased compared to those before surgery,the immune function indicators in the LAVH group were higher than those in the LM group,the differences were statistically significant(P<0.05).The total incidence of postoperative complications in the LAVH group was lower than that in the LM group,the difference was statistically significant(P<0.05).Conclusion:Compared to LM,LAVH can reduce surgical trauma and the incidence of complications in patients with HLU,as well as mitigate the impact on sexual function.