不同手术方式子宫切除术对患者生殖系统及性功能的影响

摘要

目的：探讨开腹手术与腹腔镜手术行子宫全切除术对患者生殖系统及性功能的影响。方法：择期行子宫全切除术的患者100例，按照不同的手术方式分为腹腔镜组50例和开腹组50例，开腹组采用传统开腹手术进行子宫全切除术，腹腔镜组采用腹腔镜辅助全子宫切除术。观察术前、术后6个月时患者的生殖激素以及卵巢激素水平，同时对患者的性功能进行评分，并记录患者术后的不良反应发生率。结果：两组患者LH及FSH的水平在术后6个月时显著高于术前（P＜0．05），而P与E2水平均显著低于术前（P＜0．05）。而开腹组患者的变化程度显著高于腹腔镜组（P＜0．05）。两组患者术后性功能均有所影响，但两组各项性功能项指标比较差异均无统计学意义（ P＞0．05）。两组患者术后各并发症的发生率比较差异均无统计学意义（P＞0．05）。结论：子宫切除术对患者的卵巢功能均有影响，而腹腔镜手术对卵巢功能的影响更小；但种手术方式对患者的性生活质量无影响，且均具有一定安全性。%Objective:To investigate the effects of laparoscopic operation and open operation on the repro‐ductive system of hysterectomy patients and sexual function .Methods:100 cases of uterus hysterectomy patients in Nanjing Drum tower hospital were divided into laparoscopic group with 50 cases and laparotomy group with 50 cases by the different ways of operation ,the laparotomy group were treated by traditional open operation for hysterectomy , the laparoscopic group were treated by laparoscopic assisted hysterectomy ,observation of preoperative ,postoperative 6 months in patients with reproductive hormone and ovarian hormone levels ,at the same time ,score on the sexual function of patients and the adverse reaction of patients with postoperative incidence were record .Results :LH and FSH of the two groups at the level of 6 months after operation was significantly increased ,while the P and E2 levels were significantly decreased ,and the degree of change in laparotomy group were significantly higher than those of the laparoscopic group ,the difference was statistically significant (P<0 .05);the two groups of patients in the post‐operative sexual function were affected in different degree ,but there were no significant differences between the vari‐ous function indexes of two groups of patients (P>0 .05);the incidence rate of complications of the two groups were compared statistically significant (P>0 .05) .Conclusion:Hysterectomy on ovarian function of patients are affected by laparoscopic operation ,and the influence on the ovarian function is smaller ,but the kind of operation mode of quality of sexual life of patients no significant difference and had a certain security .