摘要
目的研究输卵管处理方案选择对行腹腔镜全子宫切除术患者相关临床指标的影响。方法前瞻性研究,选择2015年1月至2017年6月在上海市浦东新区人民医院妇产科行腹腔镜全子宫切除术治疗的良性子宫病变患者78例。采用随机数字表法分为对照组和观察组,每组各39例,对照组患者保留双侧输卵管,实验组患者术中行双侧输卵管切除。比较两组患者的手术指标、激素水平、围绝经期综合征发生率和术后并发症等。结果两组患者的手术时间、术中出血量、术后肛门排气时间和住院时间相近(P>0.05)。两组患者术后1个月、3个月的抗苗勒管激素、雌二醇AMH、E2水平较术前降低,卵泡刺激素、黄体生成素水平较术前升高,差异具有统计学意义(P<0.05),两组患者术前及术后同时间点血清激素水平相近(P>0.05)。两组患者术后1个月、3个月的Kupperman评分均高于术前,差异具有统计学意义(P<0.05),但两组患者术前及术后同时间点的Kupperman评分相近,术后3个月两组患者的MPS发生率相近,差异无统计学意义(P>0.05)。观察组患者术后发生盆腔炎性疾病2例(5.13%),对照组患者术后发生盆腔炎性疾病8例(20.51%),差异具有统计学意义(P<0.05);两组患者卵巢良性肿瘤和卵巢恶性肿瘤的发病率相近,差异无统计学意义(P>0.05)。结论腹腔镜全子宫切除术会降低患者的卵巢功能,加重围绝经期症状,单纯施行全子宫切除术和术中联合双侧输卵管切除术的手术相关指标相近,对卵巢功能和围绝经期症状的影响相似,但术中联合双侧输卵管切除术降低了患者盆腔炎性疾病的发病率,建议预防性切除。
Objective To study the effect of oviduct treatment plan on related clinical indicators for patients undergoing laparoscopic total hysterectomy. Methods Seventy-eight patients with benign uterine lesions treated by laparoscopic total hysterectomy in this hospital during January 2015 to June 2017 were selected for this study. They were divided into control group and observation group by using random number table method, 39 cases in each group, patients in control group were performed with retention of fallopian tube, and patients in observation group underwent bilateral tubal resection. The surgical index, hormone level, incidence of menopausal syndrome and postoperative complications were compared between these two groups. Results The operating time, the amount of bleeding in the operation, the time for postoperative anus exhaustion and the duration for hospitalization in these two groups were similar （ P 〉0.05）. Patients in these two groups in 1 months and 3 months after the operation, the levels of anti Mullerian hormone and estradiol were decreased, follicle stimulating hormone and luteinizing hormone levels were higher than those before surgery （ P 〈0.05）, patients in these two groups before and after operation with the serum hormone level at different time points was similar （ P 〉0.05）. Two groups of patients in 1 months and 3 months after surgery, the Kupperman scores were higher than those before operation （ P 〈0.05）, but patients of these two groups before and after operation at the same time point, the scores were similar to Kupperman scores, 3 months after surgery, patients of these two groups the incidence of MPS was similar （ P 〉0.05）. Two patients （5.13%） in observation complicated with pelvic inflammatory disease of patients in the observation group of Two cases （5.13%）,and 8 pattients （20.51%%） in control group co,plicated with pelvic inflammatory disease （ P 〈0.05）, the incidence of patients in these two groups of patients with ovarian benign tumor
作者
戴晓莉
孙丽艳
张爱
杨宾烈
DAI Xiao-li;Sun Li-yan;Zhang Ai(Department of gynecology and obstetrics,People＇s Hospital of Shanghai Pudong District,Shanghai 201200,China.)
出处
《临床和实验医学杂志》
2018年第19期2118-2121,共4页
Journal of Clinical and Experimental Medicine
基金
上海市卫生和计划生育委员会科研课题面上项目(编号:201540417)
关键词
输卵管
腹腔镜
全子宫切除术
激素
围绝经期综合征
Fallopian tube
Laparoscopy
Total hysterectomy
Hormone
Perimenopausal syndrome
