摘要
目的探讨腹腔镜子宫肌瘤切除术(LM)和超声引导下经皮微波消融(MWA)治疗单发肌壁间子宫肌瘤的临床疗效。方法选取2016年4月至2018年8月漳州市中医院和漳州市芗城区妇幼保健院收治的51例单发肌壁间子宫肌瘤患者作为研究对象。其中行MWA治疗患者纳入观察组(23例),行LM治疗患者纳入对照组(28例)。比较两组手术指标及术后恢复情况、应激反应指标、并发症发生率、肌瘤残留及复发率、卵巢功能指标及性功能指标。结果与对照组比较,观察组手术时间、术后肛门排气时间和住院时间均较短,术中出血量少,术后镇痛率低(P<0.05)。术后两组去甲肾上腺素(NE)、P物质(SP)和肾上腺素(E)水平均明显上升,但观察组低于对照组;两组谷胱甘肽过氧化物酶(GSH-Px)水平下降,但观察组高于对照组(P<0.05)。观察组并发症发生率明显低于对照组(P<0.05)。观察组肌瘤残留率和复发率均明显低于对照组(P<0.05)。两组术前、术后3个月血清黄体生成素(FSH)、卵泡刺激素(LH)、雌二醇(E_(2))水平比较,差异均无统计学意义(P>0.05);与术前比较,两组术后3个月血清E_(2)水平均显著降低(P<0.05)。两组手术前后性功能指标比较差异无统计学意义(P>0.05)。结论LM和MWA治疗单发肌壁间子宫肌瘤疗效确切、安全可靠。相对于LM,MWA具有微创、手术时间短、并发症少、术后恢复快、子宫肌瘤残留率、复发率低的优势。
Objective To explore the clinical effects of laparoscopic myomectomy(LM)and microwave ablation(MWA)in the treatment of single symptomatic intramural hysteromyoma.Methods A total of 51 patients suffering single symptomatic intramural hysteromyoma admitted to Zhangzhou Traditional Chinese Medical Hospital and Zhangzhou Xiangcheng District Maternal and Child Health Hospital from April 2016 to August 2018 were selected and divided into a control group and an observation group according to patients′choice.The observation group(n=23)received MWA treatment,and the control group(n=28)received LM treatment.The operative indexes,conditions of recovery,stress response indexes,incidence of complications,residual rate and recurrence rate,ovarian function indexes,and sexual function indexes were compared between the two groups.Results Compared with the control group,the operative time,postoperative anal exhaust time and hospital stay of the observation group were shorter,the amount of intraoperative blood loss was less,and the postoperative analgesia rate was lower(P<0.05).After operation,the levels of norepinephrine(NE),substance P(SP)and epinephrine(E)in two groups were significantly increased,but the observation group was lower than the control group;The level of glutathione peroxidase(GSH-Px)decreased in both groups,but the observation group was higher than the control group(P<0.05).The incidence of complications in observation group was significantly lower than that in control group(P<0.05).The residual rate and recurrence rate of fibroids in observation group were significantly lower than those in control group(P<0.05).There were no significant differences in serum FSH,LH and E2 levels between the two groups before and 3 months after operation(P>0.05).Compared with preoperation,serum E2 level was significantly decreased in both groups 3 months after operation(P<0.05).There was no significant difference in sexual function between the two groups before and after operation(P>0.05).Conclusions LM and MWA are effective,safe and reliable in the treatment of single intramural hysteromyoma.Compared with LM,MWA has the advantages of minimally invasive,short operation time,less complications,quick postoperative recovery,low residual rate of uterine fibroids and low recurrence rate.
作者
林俊东
王祖琛
徐绍鹏
叶南芳
LIN Jundong;WANG Zuchen;XU Shaopeng;Ye Nanfang(Department of Intervention,Zhangzhou Tranditional Chinese Medical Hopital,Zhangzhou 363000,Fujian,China;Department of Maternal Health,Zhangzhou Xiangcheng District Maternal and Child Health Hospital,Zhangzhou 363000,Fujian,China;Department of Ultrasonography,Zhangzhou Tranditional Chinese Medical Hospital,Zhangzhou 363000,Fujian,China;Department of Obstetrics and Gynecology,Zhangzhou Tranditional Chinese Medical Hospital,Zhangzhou 363000,Fujian,China)
出处
《中国性科学》
2021年第4期65-69,共5页
Chinese Journal of Human Sexuality
基金
福建省漳州市自然科学基金(ZZ2017J14)。
