摘要
目的探讨"U"形子宫切除成形术治疗子宫腺肌病的临床价值。方法选取2007年8月至2014年10月在海门市人民医院妇科住院手术且均经术后病理证实为子宫腺肌病的患者118例,根据病灶范围及患者个人意愿分为3组:研究组(58例)患者接受"U"形子宫大部切除术;对照组1(28例)接受局部腺肌病病灶切除术;对照组2(32例)接受全子宫切除术。分别测定3组手术前后性激素水平及卵巢间质动脉血流,记录研究组和对照组1治疗前后的痛经情况及经量变化。结果研究组术后痛经消失或缓解率及经量减少值均高于对照组1(P<0.05)。研究组、对照组1卵巢血流阻力指数(resistance index,RI)及搏动指数(pulse index,PI)术前术后比较,差异均无统计学意义(P>0.05);对照组2治疗后6个月的卵巢血流RI及PI值明显较术前增高(P<0.05)。研究组和对照组1手术前后血清性激素比较差异无统计学意义(P>0.05);对照组2术后血清雌二醇明显降低,卵泡刺激素、黄体生成素水平明显升高,与术前比较差异有统计学意义(P<0.05)。结论 "U"形子宫切除成形术能更大限度地切除浸润的腺肌病灶,缓解痛经症状,且对女性内分泌功能影响小,不改变术后盆底组织结构,满足患者的心理及生理需要,是治疗子宫腺肌病有价值的保守性手术方法。
Objective To investigate the clinical value of the ＂ U＂ - shaped and forming hysterectomy in the treatment of adenomyosis. Methods 118 adenomyosis patients underwent surgeries at Departments of Obstetrics and Gynecology, Haimen City People＇s Hospital from August 2006 to October 2014 were selected. According to the range of lesion and personal preference, they were divided into 3 groups： patients in the study group （n = 58） received the ＂U＂ -shaped and forming hysterectomy; those in the control group 1 （ n = 28 ） received local adenomyosis lesion resection ; patients underwent total hysterectomy were selected in the control group 2 （ n = 32）. The levels of sex hormones and ovarian interstitial arterial blood flow were measured pre and post - operation in each group.The changes of dysmenorrhea and menstruation were compared between the study group and control group 1 pre and post - treatment. Results The rate of postoperative dysmenorrhea disappeared or relieved and the reducing amount of menstruation in the study group were higher than those in the control group 1, with significant difference （P 〈 0. 05）. Compared with the control group 1, resistance index （RI） of ovarian blood flow and pulse index （PI） of the patients in the study group pre and post - operation showed no significant differences （P 〉 0.05 ）. RI and PI levels in the control group 2 were higher 6 months post - operation than pre - operation, with significant differences （P 〈 0.05）. There was no significant difference in serum sex hormones between the study group and the control group 1 pre and post - operation （ P 〉 0.05 ）. Compared with the preoperative levels, the serum estradiol （ E2 ） was significantly decreased, the levels of follicle -stimulating hormone（FSH） and luteinizing hormone （LH） were significantly increased in the control group 2, and the differences were statistically significant （ P 〈 0. 05 ）. Conclusion The ＂U＂ - shaped and forming hysterectomy can not on
出处
《中国计划生育和妇产科》
2017年第3期34-38,共5页
Chinese Journal of Family Planning & Gynecotokology
