腹腔镜全子宫切除时不同方法切除双侧输卵管的临床应用葛芬芬宁波.docVIP

腹腔镜全子宫切除时不同方法切除双侧输卵管的临床应用 葛芬芬 宁波市医疗中心李惠利东部医院 妇科（浙江宁波，315000） 【摘要】 目的 探讨因子宫良性病变行腹腔镜全子宫切除时不同方法切除双侧输卵管对卵巢功能的影响。方法 选取2012年1月至2014年12月因子宫良性疾病行腹腔镜全子宫切除术的患者126例，按照输卵管的不同切除方法分为保留组（40例），传统组（43例），抽芯组（43例）。比较各组术后血清性激素水平（雌二醇E2、卵泡刺激素FSH、黄体生成素LH）、围绝经期症状、盆腔包裹性积液的变化情况。结果 术后12个月随访，传统组E2最低，与保留组和抽芯组比较差异均有统计学意义（q=3.85，P0.05；q=3.12，P0.05），抽芯组和保留组比较差异无统计学（q=0.79，P0.05）；传统组FSH最高，与保留组和抽芯组比较差异均有统计学意义（q=5.36，P0.05；q=3.44，P0.05），抽芯组和保留组比较差异无统计学（q=1.99，P0.05）；术后围绝经期症状发生率三组比较差异无统计学意义（χ2= 1.727，P0.05）；术后包裹性积液发生率保留组高于传统组和抽芯组，比较差异有统计学意义（χ2=3.88，P0.05）。结论 子宫良性疾病行腹腔镜全子宫切除术同时切除双侧输卵管可降低术后盆腔包裹性积液的发生率，其中抽芯法切除输卵管对卵巢功能无影响，是值得推广的手术方式。 【关键词】 全子宫切除术 抽芯法 输卵管切除 卵巢功能 性激素 A clinical study of laparoscopic hysterectomy with different types of salpingectomy Ge Fenfen Department of Gynecology, Ningbo Medical Center Lihuili Eastern Hospital,Zhejiang NingBo，315000,China 【Abstract】Objective To investigate the influence of laparoscopic hysterectomy with defferent types of salpingectomy on ovarian function in patients with benign uterine diseases. Methods One hundred and twenty-six patients performed laparoscopic hysterectomy for treatment of benign uterine diseases from Jan 2012 to Dec 2014 were divided into retain group(n=40)、tradition group(n=43) and core-pulling group(n=43) according to different treatment of bilateral fallopian tube. The changes of sex hormone levels,postmenopausal symptoms,and pelvic encapsulated fluid were compared among groups after 12 months. Results The tradition group showed significantly lower level of E2 than the retain and core-pulling groups（q=3.85，P0.05；q=3.12，P0.05）,no difference was found between the retain and core-pulling groups （q=0.79，P0.05）.The tradition group showed significantly higher level of FSH than the retain and core-pulling groups（q=5.36，P0.05；q=3.44，P0.05）,no difference was found between the retain and core-pulling groups （q=1.99，P0.05）. There was no significant difference in postmenopausal symptoms among