腹腔镜下子宫肌瘤摘除术治疗子宫肌瘤的临床效果观察

Observation on the clinical effect of laparoscopic myomectomy in the treatment of hysteromyoma

目的 探讨腹腔镜下子宫肌瘤摘除术治疗子宫肌瘤的临床效果。方法 120例子宫肌瘤患者,采用随机分配方式分为对照组和观察组,各60例。对照组采用开腹子宫肌瘤摘除术治疗,观察组采用腹腔镜下子宫肌瘤摘除术治疗。比较两组患者手术前后卵巢功能[促黄体生成素(LH)、窦卵泡计数(AFC)和促卵泡生成素(FSH)]、术中及术后相关指标、并发症发生情况。结果 两组术前LH、FSH、AFC比较无差异(P>0.05);观察组术后LH(17.93±4.11)U/L、FSH(19.05±4.32)U/L均低于对照组的(22.52±5.11)、(23.72±5.42)U/L, AFC(8.16±1.85)个多于对照组的(5.50±1.23)个(P<0.05)。观察组术中出血量(41.25±8.68)ml少于对照组的(91.35±8.96)ml,术后下床时间(1.25±0.73)d、肛门排气时间(1.23±0.26)d和术后住院时间(4.18±0.76)d均短于对照组的(2.16±0.98)、(2.25±0.53)、(8.16±0.82)d(P<0.05)。观察组并发症发生率1.7%低于对照组的11.7%(P<0.05)。观察组对治疗的总满意度91.7%高于照组的78.3%(P<0.05)。结论 针对子宫肌瘤患者采用腹腔镜下子宫肌瘤摘除术治疗,可以有效改善患者的卵巢功能,减少术中出血量,缩短术后下床时间、肛门排气时间和术后住院时间,并降低并发症发生率,具有一定的推广价值。

Objective To explore the clinical effect of laparoscopic myomectomy in the treatment of hysteromyoma.Methods 120 patients with hysteromyoma were randomly divided into a control group and an observation group,with 60 cases in each group.The control group was treated with open myomectomy,and the observation group was treated with laparoscopic myomectomy.The ovarian function[luteinizing hormone(LH),antral follicle count(AFC)and follicle-stimulating hormone(FSH)],intraoperative and postoperative related indicators,and the incidence of complications were compared between the two groups.Results There was no difference in the comparison of preoperative LH,FSH and AFC between the two groups(P>0.05).After operation,the observation group had LH of(17.93±4.11)U/L and FSH of(19.05±4.32)U/L,which were lower than(22.52±5.11)and(23.72±5.42)U/L in the control group;the observation group had more AFC of(8.16±1.85)than(5.50±1.23)in the control group(P<0.05).The observation group had less intraoperative blood loss of(41.25±8.68)ml than(91.35±8.96)ml in the control group;the postoperative ambulation time in the observation group was(1.25±0.73)d,the anal exsufflation time was(1.23±0.26)d,and the postoperative hospitalization time was(4.18±0.76)d,which were all shorter than(2.16±0.98),(2.25±0.53),and(8.16±0.82)d in the control group(P<0.05).The complication rate of 1.7%in the observation group was lower than 11.7%in the control group(P<0.05).The total satisfaction with the treatment in the observation group was 91.7%,which was higher than 78.3%in the control group(P<0.05).Conclusion For patients with hysteromyoma,the use of laparoscopic myomectomy can effectively improve the patient's ovarian function,reduce the intraoperative blood loss,shorten the postoperative ambulation time,anal exsufflation time and postoperative hospitalization time,and reduce the incidence of complications,which has a certain popularization value.