目的探讨腹腔镜下子宫切除与开腹子宫切除对卵巢功能及生活质量的影响。方法选择2010年1月-2014年12月丽水市妇幼保健院妇科收治的患子宫肌瘤或子宫腺肌病行子宫切除术的患者120例,随机分为对照组和观察组,每组各60例。两组患者常规术前准备,对照组行开腹子宫切除术,观察组行妇科腔镜下子宫切除术,术后给予抗感染治疗。观察两组患者手术中情况,测定卵巢功能,对患者术后相关生活质量进行评价,记录术后不良反应发生情况。结果观察组在术中出血量、手术时间、术后排气时间、住院时间等方面均优于对照组,差异有统计学意义(P<0.05)。卵巢功能测定显示,术后3个月,两组患者血清卵泡刺激素(FSH)、黄体生成素(LH)大幅度升高,至术后6个月逐渐下降,术后6个月对照组与术前相比仍具有差异(P<0.05),观察组整个治疗过程变化幅度较对照组平稳,术后6个月与术前相比,差异无统计学意义(P>0.05)。术后3个月,两组患者雌二醇(E2)大幅度降低,至术后6个月逐渐升高,术后6个月对照组与术前相比仍具有差异(P<0.05),观察组整个治疗过程变化幅度较对照组平稳,术后6个月与术前相比,差异无统计学意义(P>0.05)。对两组患者术后相关生活质量问卷进行比较发现两组患者与术前相比,术后3个月、术后6个月生活质量评分均有改善,差异有统计学意义(P<0.05),但观察组改善程度优于对照组,差异有统计学意义(P<0.05)。在不良反应方面,用药后不良反应主要为乳房胀痛、阴道少量出血以及卵巢增大等,但反应均较轻微,且对照组以及观察组各项不良反应相比较,差异无统计学意义(P>0.05)。结论妇科腹腔镜下行子宫切除术的患者具有术中创伤较小,恢复好,且术后卵巢功能变化平稳,可以有效改善患者生活质量,且无明显不良反应发生,值得临床推广应用。 Objective To investigate the effect of laparoscopic hysterectomy and open hysterectomy on ovarian function and quality of life. Methods From January 2010 to December 2014, 120 cases of patients with hysteromyoma or adenomyosis treated by gynecology in Lishui MCH hospital were randomly divided into control group and observation group with 60 example. The two groups of patients were routinely prepared preoperatively, the control group underwent open hysterectomy, the observation group underwent gynecological endoscopic hysteroscopic resection, and anti-infective treatment was given after operation. The two groups of patients were observed during operation, ovarian function was measured, the quality of life of the patients after surgery were evaluated, and recorded the incidence of adverse reactions. Results The observation group was superior to the control group in terms of blood loss, operation time, postoperative exhaust time and hospital stay, with statistical significance (P <0.05). Ovarian function tests showed that serum FSH and LH significantly increased in both groups at 3 months after operation, but gradually decreased at 6 months after operation. There was still a significant difference between before and after treatment (P <0.05). The changes of the whole course of treatment in the observation group were more stable than those in the control group. There was no significant difference between the observation group and the control group 6 months after operation (P> 0.05). At 3 months after operation, the estradiol (E2) in both groups decreased significantly and gradually increased 6 months after operation. There was still significant difference between the control group and preoperative 6 months after operation (P <0.05) The changes of the whole course of treatment in the observation group were more stable than those in the control group. There was no significant difference between the observation group and the preoperative one at 6 months (P> 0.05). The comparison of postoperative quality of life questionnaire between the two groups showed that the quality of life scores of the two groups were improved after 3 months and 6 months after operation compared with those before operation, the difference was statistically significant (P <0.05) , But the observation group improved better than the control group, the difference was statistically significant (P <0.05). Adverse reactions, the adverse reactions after treatment mainly breast pain, a small amount of vaginal bleeding and ovarian enlargement, but the response was mild, and the control group and the observation group compared to the adverse reactions, the difference was not statistically significant (P > 0.05). Conclusions Gynecological laparoscopic hysterectomy patients with less trauma, recovery, and postoperative changes in ovarian function stable, can effectively improve the quality of life of patients, and no significant adverse reactions, it is worth promoting the clinical application.