行子宫切除术治疗子宫肌瘤时子宫保留程度对卵巢功能的影响分析

目的分析腹腔镜下阴式子宫切除术对子宫肌瘤患者子宫保留程度和卵巢功能的影响。方法选取2016年12月至2018年12月陕西中医药大学第二附属医院诊治的117例子宫肌瘤患者作为研究对象。按照随机数字法进行分组,对照组行腹腔镜下阴式子宫全切术,观察组行腹腔镜下阴式子宫次全切术,观察两组患者的基本手术资料,卵巢功能情况、恢复排卵情况及生活质量。结果观察组的围术期术后镇痛(6.8±1.7)d,肛门通气(14.8±0.4)h,住院(4.3±0.7)d,尿潴留2例,均分别显著低于对照组,组间差异具有统计学意义(P<0.05)。术后1月末,观察组E2(93.6±15.4)pmol/L显著高于对照组,组间差异具有统计学意义(P<0.05);术后1月末观察组FSH(13.4±2.31)U/L、LH(24.71±7.26)U/L均显著低于对照组,组间差异具有统计学意义(P<0.05)。观察组术后3个月内QOL生活质量评分(52.62±2.90)分显著高于对照组,差异具有统计学意义(t=6.990,P<0.05)。观察组患者术后HAMD评分(16.51±1.59)分、HAMA评分(10.75±1.44)分均显著低于对照组,观察组FSFI评分(24.52±0.74)分显著高于对照组,差异均具有统计学意义,(均P<0.05)。结论腹腔镜下阴式子宫切除术,采用次全切,保留宫颈,能一定程度上加速患者术后恢复,提高患者的术后生活质量,同时,对维持卵巢功能,发挥患者体内甾体激素的合成及个体卵巢卵泡的发育有积极意义,值得临床推广。

Analysis on the effect of uterine retention on the ovarian function in the treatment of uterine fibroids by transvaginal hysterectomy

Objective To analyze the effect of transvaginal hysterectomy under laparoscopy on the ovarian function of patients with uterine fibroids.Methods 117 patients with uterine fibroids admitted to the Second Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from December 2016 to December 2018 were selected into the study.According to the random number method,all the patients were divided into the control group(transvaginal hysterectomy under laparoscopy)and the observation group(transvaginal sub-hysterectomy under laparoscopy).The perioperative basic situation,ovarian function and recovery of ovulation and quality of life of patients in the two groups were observed and compared.Results The postoperative analgesia(6.8±1.7)d],anus ventilation(14.8±0.4)h],hospitalization length(4.3±0.7)d],urinary retention(2 cases)of the observation group were significantly lower than those of the control group,with statistically significant differences(P<0.05).At a month after surgery,the E2 levelof the observation group(93.6±15.4)pmol/L]was significantly higher than that of the control group,and the levels of FSH(13.4±2.31)U/L]and LH(24.71±7.26)U/L]in the observation group were significantly lower than those in the control group,all with statistically significant differences(all P<0.05).The quality of life(QOL)score in the observation group(52.62±2.90)points]were significantly higher than those in the control group at 3 months after surgery(t=6.990,P<0.05).Postoperative HAMD score(16.51±1.59)and HAMA score(10.75±1.44)in the observation group were significantly lower than those in the control group,while FSFI score(24.52±0.74)in the observation group was significantly higher than that in the control group,with statistically significant differences(all P<0.05).Conclusions Transvaginal sub-hysterectomy under laparoscopy retains the cervix,which,to a certain extent,accelerates the postoperative recovery of patients and improves the postoperative quality of life of patients.Meanwhile,it is also conductive to maintaining the ovarian function,the synthesis of steroid hormones and individual ovarian follicle development,worthy of clinical promotion.