宫腔镜子宫肌瘤电切术治疗子宫肌瘤疗效分析

摘要

目的 探讨宫腔镜子宫肌瘤电切术(TCRM)治疗子宫肌瘤的疗效及对晚期氧化蛋白产物(AOPP)、血浆丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)的影响.方法 回顾性选取2014年1月至2016年3月在我院接受手术治疗的子宫肌瘤患者145例,根据手术方法不同分为对照组和观察组.对照组患者采用开腹手术进行治疗,观察组患者采用宫腔镜子宫肌瘤电切术进行治疗.观察两组患者手术情况、疼痛评分、性功能评分及并发症情况.比较两组患者治疗前后AOPP、MDA、GSH-Px及CRP水平.结果 观察组患者手术时间、术后肛门排气时间及术后下床时间均短于对照组患者,术中出血量和疼痛评分均少于对照组患者,差异有统计学意义(P＜0.05).对照组患者治疗24h后AOPP、MDA及CRP水平较治疗前上升,GSH-Px水平较治疗前下降,差异有统计学意义(P＜0.05).观察组患者治疗24h后AOPP水平与治疗前比较差异无统计学意义(P＞0.05).观察组患者治疗后MDA和CRP水平较治疗前上升,GSH-Px水平较治疗前下降,差异有统计学意义(P＜0.05).两组患者治疗24h后AOPP、MDA、GSH-Px及CRP水平比较差异有统计学意义(P＜0.05).观察组患者并发症率为8.22％低于对照组患者,差异有统计学意义(P＜0.05).对照组患者治疗6个月后性欲望、性唤起、阴道润度、性高潮及性生活满意度评分与治疗前比较差异无统计学意义(P＞0.05).观察组患者治疗6个月后性欲望、性唤起、阴道润度、性高潮及性生活满意度评分高于治疗前和对照组患者治疗后,差异有统计学意义(P＜0.05).结论 宫腔镜子宫肌瘤电切术治疗子宫肌瘤术后恢复快,安全性高,可改善患者机体氧化应激反应,提高患者性生活质量.%Objective To investigate the curative effect of hysteroscopic transcervical resection of myoma(TCRM) on uterine fibroids and its effects on the level of advanced oxidation protein products(AOPP),plasma malondialdehyde (MDA),glutathione peroxidase(GSH-Px).Methods 145 patients with uterine fibroids who underwent surgery in our hospital from January 2014 to March 2016 were selectedretrospectively.The patients were divided into control group and observation group according to different surgical methods.Patients in the control group were treated with laparotomy,while patients in the observation group were treated with hysteroscopic transcervical resection of myoma.The operation conditions,pain scores,sexual function scores and complications of the two groups were observed.The levels of AOPP,MDA,GSH-Px and CRP in both groups before and after treatment were compared.Results The duration of operation,the time of postoperative anal exhaust and the time of getting out of bed of the observation group were shorter than those of the control group.The bleeding volume during operation and pain score were less in the observation group than in the control group,with statistical significance (P ＜ 0.05).The levels of AOPP,MDA and CRP in control group increased 24 hours after treatment,and the level of GSH-Px decreased compared with that before treatment,with statistical significance (P ＜ 0.05).There was no significant difference of AOPP levelsin the observation group before and after treatment (P ＞ 0.05).The levels of MDA and CRP in the observation group were higher than those before treatment,and the level of GSH-Px in the observation group was significantly lower than that before treatmen(P ＜ 0.05).The levels of AOPP,MDA,GSH-Px and CRP in the two groups 24h after treatment were significantly different (P ＜ 0.05).The complication rate in the observation group was 8.22％,which was lower than that in the control group,with statistical significance(P ＜ 0.05).Sexual desire,sexual arousal,vaginal discharge,orgasm and sex life satisfaction scores of patients in the control group 6 months after treatment were not significantly different from those before treatment (P ＞ 0.05).Sexual desire,sexual arousal,vaginal discharge,orgasm and sex life satisfaction scores in observation group were higher than those before treatment and control group after 6 months of treatment(P ＜ 0.05).Conclusion Patients underwent hysteroscopic transcervical resection of myoma recovery faster after surgery and the safety are better ensured.Besides,the patient's oxidative stress response and quality of sexual life are improved.