摘要
目的探究腹腔镜下双瓣法病灶切除术对子宫腺肌病患者手术指标、月经恢复及血清乙酰肝素酶(HPA)水平的影响。方法选择2019年6月—2021年6月丽水市人民医院收治的120例子宫腺肌病患者为研究对象,利用随机数字表法分为对照组(60例,采用子宫动脉栓塞术进行治疗)与研究组(60例,采用腹腔镜下双瓣法病灶切除术进行治疗),收集患者的临床资料并比较两组患者手术指标、月经恢复能力、痛经疼痛评分、血清HPA水平的变化及术后复发情况。结果与对照组[(92.08±18.72)min、(3.06±0.64)d、(187.69±37.65)ml、(9.06±2.15)d]相比,研究组子宫腺肌病患者的手术时间[(80.02±16.61)min]、术后腹腔引流时间[(2.15±0.47)d]、术中出血量[(126.55±28.53)ml]及住院时间[(7.86±1.67)d]均明显降低(P<0.05)。治疗前,两组患者的月经量、月经经期、痛经程度评分及血清HPA水平比较,差异均无统计学意义(均P>0.05);治疗后,两组患者的月经量、月经经期、痛经程度评分及血清HPA水平均明显降低(P<0.05),且上述指标研究组降低程度更为明显(P<0.05)。与对照组相比,研究组术后复发的总发生率显著降低(P<0.05)。结论腹腔镜下双瓣法病灶切除术治疗子宫腺肌病效果确切,能够显著改善患者的手术指标与月经恢复能力,抑制血清HPA的表达,并显著降低患者术后的复发率。
Objective To investigate the impacts of laparoscopic double valve lesion resection on the surgical indexes,menstruation recovery and serum heparanase(HPA)level in patients with adenomyosis(AM).Methods A total of 120 patients with AM admited to our hospital from June 2019 to June 2021 were randomly divided into the control group(60 patients,treated with uterine artery embolization)and the study group(60 patients,treated with laparoscopic double valve lesion resection).The clinical data of the patients were collected and the changes of surgical indexes,menstruation recovery ability,dysmenorrhea pain score,serum HPA level and postoperative recurrence were compared between the two groups.Results Compared with the control group[(92.08±18.72)min,(3.06±0.64)d,(187.69±37.65)ml,(9.06±2.15)d],the operation time[(80.02±16.61)min],postoperative abdominal drainage time[(2.15±0.47)d],intraoperative bleeding volume[(126.55±28.53)ml] and hospital stay[(7.86±1.67)d]of AM patients in the study group were obviously lower(P<0.05).Before treatment,there was no obvious diference in menstrual volume,menstrual period,dysmenorrhea score and serum HPA level between the two groups(P>0.05);afer treatment,the menstrual volume,menstrual period,dysmenorrhea score and serum HPA level of AM patients in both groups were obviously reduced(P<0.05),moreover,the reduction of the above indicators in the study group was more obvious(P<0.05).Compared with the control group,the total incidence of postoperative recurrence in the study group was obviously lower(P<0.05).Conclusion Laparoscopic double valve lesion resection is effective in the treatment of AM,which can obviously improve the surgical indicators and menstruation recovery ability of patients,inhibit the expression of serum HPA,and obviously reduce the recurrence rate of patients after surgery.
作者
叶夏斌
林小燕
郭学齐
YE Xia-bin;LIN Xiao-yan;GUO Xue-qi(Department of Obstetrics and Gynecology,Lishui People's Hospital,Lishui,Zhejiang 323000,China)
出处
《中国妇幼保健》
CAS
2023年第19期3813-3816,共4页
Maternal and Child Health Care of China
基金
浙江省卫生健康科技计划“青年创新人才项目”(2022KY1438)。
