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目的:探讨不同的手术方式治疗子宫腺肌瘤的疗效以及对卵巢功能的影响。方法:收集49例子宫腺肌瘤患者,按照不同手术方式分为两组,观察组(26例)采用腹腔镜下子宫次全切除术,对照组(23例)采用腹腔镜下腺肌瘤剔除术,比较分析两组患者的疗效和术后的卵巢功能。结果:观察组患者痛经全部缓解。对照组痛经21例缓解,缓解率91.3%,两组间的差异无统计学意义(P>0.05);两组患者手术后月经量明显减少,但是观察组减少更为明显,比较差异有统计学意义(P<0.01);观察组血红蛋白在术前、术后1、3、6、12个月血红蛋白分别为(76.12±8.94)g/L,(97.37±11.33)g/L,(104.91±9.24)g/L,(127.54±7.61)g/L,(125.34±6.97)g/L,与对照组同期血红蛋白比较,差异有统计学意义(P<0.05)。两组患者手术前后促卵泡生成素(FSH)、黄体生成素(LH)、雌二醇(E2)水平的差异无统计学意义(P>0.05)。结论:子宫次全切除术和子宫腺肌瘤剔除术两种不同的手术方式各有优势,两种术式短期对卵巢功能无影响,临床上应根据患者病情尽量保留子宫和卵巢。
Objective: To explore the different surgical methods of treatment of adenomyosis efficacy and ovarian function. Methods: 49 cases of adenomyosis were collected and divided into two groups according to different operation methods. The observation group (26 cases) was treated by laparoscopic subtotal hysterectomy and the control group (23 cases) by laparoscopic adenomyosis Surgery, comparative analysis of two groups of patients and postoperative ovarian function. Results: All patients in observation group were relieved of dysmenorrhea. In the control group, 21 cases of dysmenorrhea were relieved and the remission rate was 91.3%. There was no significant difference between the two groups (P> 0.05). The amount of menstrual flow in the two groups decreased significantly after operation, but the decrease in the observation group was more obvious (76.12 ± 8.94) g / L, (97.37 ± 11.33) g / L, (104.91 ± 9.24), P <0.01, respectively. The hemoglobin in observation group was g / L, (127.54 ± 7.61) g / L and (125.34 ± 6.97) g / L respectively. There was significant difference between the two groups (P <0.05). There were no significant differences in the levels of FSH, LH and E2 before and after operation in both groups (P> 0.05). Conclusion: There are two advantages for subtotal hysterectomy and adenomyosis, and the two methods have no effect on ovarian function in short term. The uterus and ovary should be reserved according to the patients’ condition clinically.