论文部分内容阅读
目的探讨阔韧带肌瘤、子宫下段肌瘤、宫颈肌瘤等复杂子宫肌瘤腹腔镜下全子宫切除的可行性。方法选取2013年2月-2016年2月在武汉商职医院妇产科就诊的102例复杂子宫肌瘤患者为研究对象,按抽签法分为对照组和研究组,每组51例。对照组予以开腹全子宫切除治疗,研究组予以腹腔镜下全子宫切除治疗,比较两组手术情况、炎性因子、免疫功能、卵巢功能和术后并发症的差异。结果研究组出血量、肛门排气时间、住院时间优于对照组,差异有统计学意义(P<0.05),两组手术时间比较,差异无统计学意义(P>0.05)。研究组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)水平低于对照组,研究组CD_3~+、CD_4~+、CD_4~+/CD_8~+高于对照组,研究组CD_8~+低于对照组,差异有统计学意义(P<0.05)。两组卵巢功能比较,差异无统计学意义(P>0.05)。研究组术后并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论灵活掌握手术技巧,复杂子宫肌瘤腹腔镜下全子宫切除是安全和可行的。
Objective To investigate the feasibility of laparoscopic hysterectomy in patients with complex uterine fibroids such as broad ligament myoma, lower uterine fibroids and cervical myomas. Methods From February 2013 to February 2016, 102 patients with complicated uterine fibroids treated in obstetrics and gynecology department of Wuhan Commercial Hospital were enrolled. The patients were divided into control group and study group according to the way of lottery, with 51 cases in each group. The control group was given an open abdominal hysterectomy. The study group was treated with laparoscopic total hysterectomy. The differences of the operation conditions, inflammatory factors, immune function, ovarian function and postoperative complications were compared between the two groups. Results The bleeding volume, anal exhaust time and hospital stay in study group were significantly better than those in control group (P <0.05). There was no significant difference in operative time between the two groups (P> 0.05). The levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in the study group were lower than those in the control group. The levels of CD_3 ~ +, CD_4 ~ + and CD_4 ~ + / CD_8 ~ + in the study group were higher than those in the control group , The study group CD_8 ~ + lower than the control group, the difference was statistically significant (P <0.05). Ovarian function between the two groups, the difference was not statistically significant (P> 0.05). The incidence of postoperative complications in the study group was lower than that in the control group, the difference was statistically significant (P <0.05). Conclusion Flexible surgical techniques, laparoscopic hysterectomy hysterectomy is safe and feasible.