子宫肌瘤宫腔镜电切术与腹腔镜剔除术临床疗效对比及对E2、LH、FSH水平的影响OA

Objective To compare the clinical efficacy of transcervical resection of myoma(TCRM)and laparoscopic myomectomy(LM),and their effect on estradiol(E2),luteinizing hormone(LH)and follicle-stimulating hormone(FSH)levels.Methods A total of 118 patients with uterine fibroids were enrolled,and randomly assigned to a TCRM group(n=59)and an LM group(n=59)by using random number table method.Operative indicators,ovarian reserve function parameters(E2,LH and FSH),endometrial receptivity indicators[pulsatility index(PI),resistance index(RI)and endometrial thickness(ET)],micro-inflammatory status indicators[IL-1β,IL-6 and tumor necrosis factor-α(TNF-α)],and complication rate were compared between the two groups.Results Compared with the LM group,the TCRM group had significantly shorter operative time,postoperative flatus time,and hospital stay,as well as significantly less intraoperative blood loss(all P＜0.001).No statistically significant differences were found in E2,LH,or FSH levels between the two groups before surgery or at 6 months postoperatively(all P＞0.05).At 1 month postoperatively,both groups showed significantly decreased PI and RI,and significantly increased ET compared with preoperative values(all P＜0.05),with greater improvements in the TCRM group(all P＜0.001).On postoperative day 3,IL-1β,IL-6,and TNF-α levels were significantly higher in both groups compared with preoperative values(all P＜0.05),and these levels were significantly lower in the TCRM group than those in the LM group(all P＜0.001).There was no statistically significant difference in complication rate between the two groups.Conclusion In the short-term observation of patients with uterine fibroids,TCRM and LM have comparable effect on ovarian reserve function and complication rate.TCRM outperforms LM in optimizing perioperative indicators,improving short-term postoperative endometrial receptivity,and alleviating early postoperative micro-inflammatory status.