| 王 锐,邬 玮,徐福霞,李 杰,高和平.腹腔镜子宫肌瘤剔除术与开腹手术对子宫肌瘤患者内分泌状态、免疫功能和预后的影响[J].,2020,(16):3160-3163 |
| 腹腔镜子宫肌瘤剔除术与开腹手术对子宫肌瘤患者内分泌状态、免疫功能和预后的影响 |
| Effects of Laparoscopic Myomectomy and Laparotomy on Endocrine Status, Immune Function and Prognosis of Patients with Uterine Myoma |
| 投稿时间：2020-02-23 修订日期：2020-03-17 |
| DOI：10.13241/j.cnki.pmb.2020.16.035 |
| 中文关键词: 腹腔镜 子宫肌瘤剔除术 开腹手术 子宫肌瘤 内分泌状态 |
| 英文关键词: Laparoscopic Myomectomy Laparotomy Hysteromyoma Endocrine status |
| 基金项目:安徽省高等学校人文社科研究项目(12925SK2018B09) |
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| 中文摘要: |
| 摘要 目的：探讨腹腔镜子宫肌瘤剔除术与开腹手术对子宫肌瘤患者内分泌状态、免疫功能和预后的影响。方法：选取2014年1月~2019年1月期间我院收治的子宫肌瘤患者90例，根据手术方式的不同将患者分为A组（n=44）和B组（n=46），A组予以开腹手术，B组予以腹腔镜子宫肌瘤剔除术，比较两组患者临床指标、内分泌状态、免疫功能、并发症及预后。结果：两组手术时间对比未见统计学差异（P>0.05）；B组术中出血量少于A组，住院时间、术后肛门排气恢复时间短于A组（P<0.05）。两组术后1个月卵泡刺激素（FSH）、促黄体生成激素（LH）均较术前升高，雌二醇（E2）较术前降低（P<0.05）；B组术后1个月FSH、LH低于A组，E2则高于A组（P<0.05）。两组术后1 d CD3+、CD4+、CD4+/ CD8+均较术前降低，但B组高于A组（P<0.05）；CD8+较术前升高，但B组低于A组（P<0.05）。B组的并发症发生率低于A组（P<0.05）。两组子宫形态正常率、复发率、月经转归正常率对比无差异（P>0.05）。结论：与开腹手术相比，腹腔镜子宫肌瘤剔除术可明显减轻对子宫肌瘤患者机体内分泌状态、免疫功能的损害，促进患者术后恢复，减少并发症发生情况，同时还可获得与开腹手术相当的近期预后。 |
| 英文摘要: |
| ABSTRACT Objective: To investigate the effects of laparoscopic myomectomy and laparotomy on endocrine status, immune function and prognosis of patients with uterine fibroids. Methods: From January 2014 to January 2019, 90 patients with hysteromyoma in our hospital were selected, they were divided into group A (n=44) and group B (n=46) according to the different operation methods. Group A received laparotomy, and group B received laparoscopic hysteromyomectomy. The clinical indexes, endocrine status, immune function, complications and prognosis of the two groups were compared. Results: There was no statistical difference in the operation time between the two groups (P>0.05). The intraoperative hemorrhage in group B was less than that in group A, and the hospitalization time and recovery time of anal exhaust after operation were shorter than those in group A (P<0.05). Follicular stimulating hormone (FSH) and luteinizing hormone (LH) in both groups at 1 month after operation were increased than before operation, and estradiol (E2) was decreased than before operation (P<0.05). FSH and LH in group B at 1 month after operation were lower that in group A, and E2 was higher than that in group A (P<0.05). CD3+, CD4+, CD4+/CD8+ in both groups at 1d after operation were lower than before operation, but the group B were higher than group A (P<0.05). CD8+ was higher than before operation, but the group B were lower than group A (P<0.05). The incidence of complications in group B was lower than that in group A (P<0.05). There were no significant differences between the two groups in the normal rate of uterine morphology, the recurrence rate and the normal rate of menstrual transition (P>0.05). Conclusion: Compared with laparotomy, laparoscopic myomectomy can significantly reduce the damage to the endocrine state and immune function of patients with hysteromyoma, promote the postoperative recovery of patients, reduce the incidence of complications, and at the same time, it can obtain the same short-term prognosis as laparotomy. |
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