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目的探讨腹腔镜下全子宫切除术加输卵管切除术对围绝经期妇女的影响。方法抽取2013年2月—2015年8月郑州大学第二附属医院收治的94例子宫良性疾病患者,通过随机数字表法分组,各47例。对照组采用腹腔镜下全子宫切除术,研究组联合采用腹腔镜下全子宫切除术及输卵管切除术,术后3、12个月进行随访,统计两组术后不同时间段围绝经期症状、盆腔包裹性积液发生率,分析手术前后黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)、搏动指数(PI)、阻力指数(RI)、舒张末期最小血流速度(V_(min))、收缩期血流峰值速度(V_(max))变化情况。结果研究组术后3、12个月时围绝经期症状发生率(6.38%、29.79%)与对照组(8.51%、27.66%)比较,差异无统计学意义(P>0.05);术前两组LH、FSH、E2水平对比,差异无统计学意义(P>0.05),术后两组LH、FSH、E2水平均较术前增高,差异有统计学意义(P<0.05),但组间对比差异无统计学意义(P>0.05);术前两组PI、RI、Vmin、Vmax水平对比,差异无统计学意义(P>0.05),术后两组PI、RI水平较术前增高,Vmin、Vmax水平较术前降低,差异有统计学意义(P<0.05),但组间对比差异无统计学意义(P>0.05);研究组盆腔包裹性积液发生率(2.13%)低于对照组(17.02%),差异有统计学意义(P<0.05)。结论围绝经期妇女采用腹腔镜下全子宫切除术加输卵管切除术可降低盆腔包裹性积液发生率,且对围绝经期症状、卵巢功能及血流影响与未切除输卵管手术无明显差异。
Objective To investigate the effect of laparoscopic total hysterectomy and tubal excision on perimenopausal women. Methods A total of 94 patients with benign uterine disease who were admitted to the Second Affiliated Hospital of Zhengzhou University from February 2013 to August 2015 were selected and divided into two groups according to the random number table method, 47 cases each. The control group received laparoscopic hysterectomy. The study group was treated with laparoscopic hysterectomy and tubal resection. The follow-up was performed 3 and 12 months after surgery. The postmenopausal symptoms, The incidence of pelvic fluid encapsulation was analyzed. The levels of LH, FSH, E2, PI, RI, and minimum end diastolic velocity (V_ (min)), peak systolic blood flow velocity (V_ (max)) changes. Results The incidence of perimenopausal symptom (6.38%, 29.79%) in the study group at 3 and 12 months after operation was not significantly different from that in the control group (8.51%, 27.66% There was no significant difference in the levels of LH, FSH and E2 between the two groups (P> 0.05). The levels of LH, FSH and E2 in the two groups after operation were significantly higher than those before operation (P <0.05) There was no significant difference between the two groups (P> 0.05). There was no significant difference in the levels of PI, RI, Vmin and Vmax between the two groups before operation (P> 0.05) (P <0.05), but there was no significant difference between the two groups (P> 0.05). The incidence of pelvic fluid encapsulation in study group (2.13%) was lower than that of preoperative Control group (17.02%), the difference was statistically significant (P <0.05). Conclusion perimenopausal women using laparoscopic hysterectomy plus Salpingectomy may reduce the incidence of pelvic encapsulated fluid, and perimenopausal symptoms of ovarian function and blood Influence uncut tubal surgery no significant difference.