腹腔镜子宫肌瘤剔除术与宫腔镜子宫肌瘤电切术治疗子宫肌瘤伴不孕的效果比较

Laparoscopic myomectomy versus hysteroscopic electrotomy of myoma for hysteromyoma complicated with infertility

  • 摘要:
      目的  比较腹腔镜子宫肌瘤剔除术与宫腔镜子宫肌瘤电切术治疗子宫肌瘤伴不孕的效果。
      方法  选取88例子宫肌瘤伴不孕患者,根据治疗方法分为对照组(采用腹腔镜子宫肌瘤剔除术治疗)与研究组(采用宫腔镜子宫肌瘤电切术治疗),每组44例。比较2组治疗效果。
      结果  研究组手术时间、术后肛门排气时间、术中出血量显著优于对照组(P < 0.05); 术后6个月时, 2组黄体生成素(LH)、卵泡刺激素(FSH)、雌二醇(E2)均基本恢复到术前水平,差异无统计学意义(P>0.05); 术后随访12个月, 2组复发率、妊娠率均无显著差异(P>0.05); 研究组术后首次妊娠时间显著短于对照组(P < 0.05)。
      结论  子宫肌瘤伴不孕治疗中,腹腔镜子宫肌瘤剔除术与宫腔镜子宫肌瘤电切术对卵巢储备功能影响均较小,可改善妊娠率,控制复发。相较于腹腔镜子宫肌瘤剔除术,宫腔镜子宫肌瘤电切术可更好地控制手术创伤,减少术中出血,缩短术后首次妊娠时间。

     

    Abstract:
      Objective  To compare the efficiency between laparoscopic myomectomy and hysteroscopic electrotomy of myoma in treatment of hysteromyoma complicated with infertility.
      Methods  Eighty-eight hysteromyoma patients with infertility were selected and divided into control group (treated by laparoscopic myomectomy) and study group (treated by hysteroscopic electrotomy of myoma), with 44 cases in each group. The therapeutic effect was compared between two groups.
      Results  The operation time, anal exhaust time and intra-operative bleeding volume of the study group were significantly better than those of the control group (P < 0.05). At 6 months after operation, luteinizing hormone (LH), follicle stimulating hormone (FSH) and estradiol (E2) in both groups recovered to the preoperative level, and there was no significant difference (P>0.05). After 12 months of follow-up, there were no significant differences in the recurrence rate and pregnancy rate between two groups (P>0.05). The time to first pregnancy after operation in the study group was significantly shorter than that in the control group (P < 0.05).
      Conclusion  In the treatment of hysteromyoma complicated with infertility, both laparoscopic myomectomy and hysteroscopic electrotomy of myoma have less impact on ovarian reserve function, which can improve pregnancy rate and control recurrence. Compared with laparoscopic myomectomy, hysteroscopic electrotomy of myoma can better control surgical trauma, reduce intra-operative bleeding and shorten the time to first pregnancy after operation.

     

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