子宫肌瘤患者开腹手术与腹腔镜手术术后的抑郁评分及预后

Depression score and prognosis in patients with uterine fibroids undergoing laparotomy and laparoscopic surgery

目的探讨子宫肌瘤患者开腹手术与腹腔镜手术术后抑郁评分及预后。方法选取2016年1月至2018年6月间辽阳市第三人民医院收治的140例子宫肌瘤患者作为主要研究对象,采用开腹子宫肌瘤剔除术治疗的70例患者纳入基础组,采用腹腔镜下子宫肌瘤剔除术治疗的70例患者纳入研究组,比较两组患者治疗前后的抑郁自评量表(SDS)评分及术后1年的并发症发生情况,并发症包括胃肠道反应、肩背酸痛、皮下气肿、子宫肌瘤复发情况以及盆腔粘连发生情况。结果治疗前,两组患者的SDS评分比较,差异无统计学意义(P> 0. 05)。治疗后,研究组的SDS评分为(45. 19±4. 22)分,低于基础组的(52. 34±4. 79)分,差异有统计学意义(P <0. 05)。术后1年,研究组术后并发症发生率为2. 9%(2/70),低于基础组的18. 6%(13/70);研究组患者子宫肌瘤的复发率为4. 3%(3/70),低于基础组的14. 3%(10/70);研究组发生盆腔粘连概率为11. 4%(8/70),低于基础组的25. 7%(18/70),差异均有统计学意义(均P <0. 05)。结论腹腔镜手术能够降低子宫肌瘤患者的抑郁情绪,减少并发症发生率、复发率和盆腔粘连率,治疗子宫肌瘤的效果更优,建议在临床上采用腹腔镜手术治疗子宫肌瘤。

Objective To investigate the effects of laparotomy and laparoscopic surgery on depression score and prognosis in patients with uterine fibroids.Methods A total of 140 patients with uterine fibroids who were treated at Third People’s Hospital of Liaoyang from January 2016 to June 2018 were selected as the subjects.The patients were divided into a study group and a basic group with 70 patients in each group by random number table method.The fundamental myomectomy was performed in the basic group,and the laparoscopic myomectomy was performed in the study group.The self-rating depression scale(SDS)scores before and after treatment and incidence of complications at 1 year after the surgery were compared between the two groups including gastrointestinal reactions,shoulder pain,subcutaneous emphysema,recurrence of uterine fibroids,and pelvic adhesions.Results Before the treatment,there was no significant difference in the SDS scores between the study group and the basic group(P>0.05).After the treatment,the SDS score was 45.19±4.22 in the study group which was lower than 52.34±4.79 of the baseline group(P<0.05).At 1 year after the surgery,the incidence of complication was 2.9%(2/70)in the study group,which was lower than 18.6%(13/70)of the basic group.The recurrence rate of uterine fibroids was 4.3%(3/70)in the study group,which was lower than 14.3%(10/70)of the basic group.The incidence of pelvic adhesion was 11.4%(8/70)in the study group,which was lower than 25.7%of the basic group(all P<0.05).Conclusion Laparoscopic surgery can reduce depression,complications,recurrence rate and pelvic adhesion rate in patients with uterine fibroids.Its efficacy in treating uterine fibroids is good.It is recommended to use laparoscopic surgery for uterine fibroids in clinical practice.