摘要
目的探讨阴式子宫肌瘤剔除手术(VM)对子宫平滑肌瘤患者术后康复及复发率的影响。方法2018年1月至2023年6月我院收治的598例子宫平滑肌瘤患者,根据手术方式分组,行VM手术的302例患者纳入阴式组,行腹腔镜下子宫肌瘤剔除术(LM)的296例患者纳入腹腔组,观察两组患者手术情况,术后康复状况、并发症发生情况,术前及术后3个月时检测患者卵巢功能,术后3个月时月经正常恢复情况,术后6个月时子宫肌瘤复发情况。结果阴式组患者术中循环血容量丢失、术中耗时、肠鸣音恢复时间、肛门排气恢复时间、留院观察时长、术后疼痛感及术后并发症发生率明显低于腹腔组(P<0.05);两组患者肌瘤剔除个数差异无统计学意义(P>0.05);术后3个月随访两组患者血清抗苗勒管激素(AMH)、雌二醇(E2)水平显著降低(P<0.05),血清促卵泡激素(FSH)、促黄体生成素(LH)水平明显升高(P<0.05),且阴式组AMH与E2水平高于腹腔组,FSH与LH低于腹腔组(P<0.05);阴式组患者术后3个月时月经正常恢复率明显高于腹腔组(P<0.05),术后6个月时复发率低于腹腔组(P<0.05)。结论VM手术治疗子宫平滑肌瘤患者治疗效果良好,患者术后恢复较LM手术更快,术后并发症少,对患者卵巢功能影响小,其安全性较好,且能有效预防术后复发。
Objective To explore the influence of vaginal myomectomy(VM)on postoperative rehabilitation and recurrence rate in patients with uterine leiomyoma.Methods Five hundred and ninety-eight patients with uterine leiomyoma were enrolled in our hospital from January 2018 to June 2023.According to the surgical methods,302 patients who underwent VM were included in a vaginal group,and 296 patients receiving laparoscopic myomectomy(LM)were enrolled as an abdominal group.The surgical situation,postoperative rehabilitation status and occurrence of complications in the two groups were observed.The ovarian function before and after 3 months of surgery,normal recovery status of menstruation after 3 months of surgery and recurrence of uterine leiomyoma after 6 months of surgery were detected.Results The intraoperative circulation blood volume loss,intraoperative duration,gastrointestinal peristalsis recovery time,anal exhaust recovery time,stay for hospital observation,pain perception and incidence rates of postoperative complications in the vaginal group were significantly less or shorter than those in the abdominal group(P<0.05).There was no statistical significance in the number of removed fibroids between the two groups(P>0.05).The levels of serum anti-Mullerian hormone(AMH)and estradiol(E2)after 3-month follow-up of surgery were obviously reduced in the two groups(P<0.05)while the levels of serum follicle stimulating hormone(FSH)and luteinizing hormone(LH)were enhanced significantly(P<0.05).The levels of AMH and E2 were higher while the levels of FSH and LH were lower in the vaginal group than those in the abdominal group(P<0.05).The normal recovery rate of menstruation in the vaginal group was significantly higher than that in the abdominal group after 3 months of surgery(P<0.05). After 6 months of surgery,the recurrence rate in the vaginal group was obviously lower than that in the abdominal group(P<0.05).Conclusions VM has a good therapeutic effect in the treatment of patients with uterine leiomyoma.Its postoperative recovery of patients is faster than that of LM.It has fewer postoperative complications,smaller impact on ovarian function and better safety.It can effectively prevent the postoperative recurrence.
作者
白晓燕
尹倩倩
袁明圆
牛兆园
BAI Xiao-yan;YIN Qian-qian;YUAN Ming-yuan;NIU Zhao-yuan(Department of Gynaecology,Jiaozhou Central Hospital,Qingdao 266300,China;Department of Gynaecology,Qingdao University Hospital,Qingdao 266000,China)
出处
《实用医院临床杂志》
2024年第3期64-68,共5页
Practical Journal of Clinical Medicine
基金
2022~2024年青岛市市级临床重点专科妇产科专科资助
山东省青岛市医药卫生科研基金资助项目(编号:2021-WJZD121)。
关键词
阴式子宫肌瘤剔除术
子宫平滑肌瘤
术后康复
复发率
Vaginal myomectomy
Uterine leiomyoma
Postoperative rehabilitation
Recurrence rate
