腹式、阴式及腹腔镜子宫切除术治疗子宫肌瘤的临床观察及对卵巢功能的影响比较

Clinical comparison of abdominal,vaginal and laparoscopic hysterectomy on uterine leiomyoma and its effect on ovarian function

目的观察腹式、阴式及腹腔镜子宫切除术治疗子宫肌瘤的手术相关情况及对卵巢功能的影响。方法选取该院收治的子宫肌瘤患者106例,根据患者肌瘤部位大小等情况,将患者分为腹式组38例、阴式组36例及腹腔镜组32例,腹式组患者采用腹式子宫切除术,阴式组患者采用阴式子宫切除术,腹腔镜组患者采用腹腔镜子宫切除术,比较不同治疗方案的手术相关情况及对患者卵巢功能的影响。结果腹腔镜组与阴式组在术后并发症发生率、住院时间、排气时间、术中出血量、手术时间均优于腹式组,差异均有统计学意义(P<0.05);而腹腔镜组与阴式组上述观察指标比较差异无统计学意义(P>0.05)。术前、术后3组患者LH、E_2、FSH比较差异均无统计学意义(P>0.05)。结论腹腔镜子宫切除术与阴式子宫切除术治疗子宫肌瘤患者整体效果优于腹式子宫切除术。

Objective To compare the clinical effects of abdominal,vaginal and laparoscopic hysterectomy for uterine fibroids and its influence on ovarian function. Methods 106 patients with uterine fibroids were taken as the research objects,and according to the patient's tumor size and other conditions,the patients were divided into abdominal group( n = 38),negative group( n = 36) and laparoscopic group( n = 32). Abdominal group was given the abdominal hysterectomy,while negative group was given the vaginal hysterectomy and laparoscopic group was given the laparoscopic hysterectomy. The surgery-related situation and the influence of ovarian function of different treatment regimens were compared. Results The complication rate,hospital stay,exhaust time,intraoperative blood loss and operation time of laparoscopic group and vaginal group were better than those of abdominal group,the differences were statistically significant( P < 0. 05). There was no statistically significant difference in above observation indicators between laparoscopic group and vaginal group( P > 0. 05). There was no significant difference in LH,E2,FSH between the three groups before and after operation( P >0. 05). Conclusion The overall effect of laparoscopic hysterectomy and vaginal hysterectomy in treatment of patients with uterine fibroids are better than abdominal hysterectomy.