不同缝合方法对腹腔镜下直径≥10 cm子宫肌瘤剔除术患者术后康复及卵巢功能的影响OA
Impact of different suture methods on postoperative recovery and ovarian function in patients undergoing laparoscopic myomectomy for uterine fibroids with a diameter of ≥10 cm
目的 探究不同缝合方法对腹腔镜下直径≥10 cm子宫肌瘤剔除术患者术后康复及卵巢功能的影响.方法 纳入2023年8月—2025年1月南京医科大学第二附属医院收治的88例直径≥10 cm子宫肌瘤患者,均行腹腔镜下子宫肌瘤剔除术治疗,采用随机数字表法分为两组,各44例,常规组采取传统连续法缝合,改良组采取改良棒球式缝合法缝合.比较两组手术相关指标、术后康复指标以及并发症发生情况,同时比较两组手术前后宫颈微循环指标、黄体生成素(LH)、雌二醇、卵泡刺激素(FSH)、抗米勒管激素(AMH)以及窦卵泡计数(AFC)水平.结果 两组手术时间、缝合时间比较差异无统计学意义(P＞0.05).改良组术中失血量及手术前后血红蛋白下降值低于常规组,首次下床时间、肛门排气时间、住院天数均短于常规组(P＜0.05).术后24、48 h,改良组毛细血管管径、血流灌注、微血管管径均高于常规组(P＜0.05).术后1、3个月,改良组血清雌二醇、AMH水平及AFC高于常规组,血清FSH、LH水平低于常规组(P＜0.05).改良组并发症总发生率为2.27％(1/44),与常规组的11.36％(5/44)比较差异无统计学意义(P＞0.05).结论 腹腔镜下直径≥10 cm子宫肌瘤剔除术中采用改良棒球式缝合法缝合能减少术中出血,加快围术期恢复进程,有助于改善宫颈微循环,提高卵巢功能,且有良好的安全性.
Objective To investigate the impact of different suture methods on postoperative recovery and ovarian function in patients undergoing laparoscopic myomectomy for uterine fibroids with a diameter of ≥10 cm.Methods A total of 88 patients with uterine fibroids with a diameter of ≥10 cm who were admitted to the Second Affiliated Hospital of Nanjing Medical University from August 2023 to January 2025 were included.All of them underwent laparoscopic myomectomy.They were divided into two groups using random number table method,with 44 patients in each group.The conventional group used the traditional continuous suture method,while the modified group used the modified baseball suture method.The surgery-related indicators,postoperative rehabilitation indicators,and occurrence of complications were compared between the two groups.In the meantime,the cervical microcirculation indicators,luteinizing hormone(LH),estradiol,follicle-stimulating hormone(FSH),anti-Müllerian hormone(AMH),and antral follicle count(AFC)levels before and after the surgery were compared between the two groups.Results There was no significant difference in the comparison of the duration of operation and suture time between the two groups(P＞0.05).The intraoperative blood loss and the decrease in hemoglobin before and after the surgery in the modified group were lower than those in the conventional group,and time to first ambulation,time to flatus,and the length of hospital stay were shorter in the modified group than in the conventional group(P＜0.05).At 24 and 48 h after the surgery,the capillary diameter,blood perfusion,and microvascular diameter in the modified group were higher than those in the conventional group(P＜0.05).At 1 and 3 months after the operation,the serum estradiol,AMH levels,and AFC in the modified group were higher than those in the conventional group,while the serum FSH and LH levels were lower than those in the conventional group(P＜0.05).The total incidence of complications in the modified group was 2.27％(1/44),which was not significantly different from 11.36％(5/44)in the conventional group(P＞0.05).Conclusion In laparoscopic myomectomy for uterine fibroids with a diameter of ≥1 0 cm,the application of the modified baseball suture method can reduce intraoperative blood loss,accelerate the recovery process during the perioperative period,help improve cervical microcirculation,enhance ovarian function,and has good safety.
刘玲;应小燕;陆乐
南京医科大学第二附属医院妇产科,南京 210000||南京市红十字医院妇产科,南京 210000南京医科大学第二附属医院妇产科,南京 210000南京市红十字医院妇产科,南京 210000
子宫肌瘤腹腔镜改良棒球式缝合法窦卵泡计数抗米勒管激素宫颈微循环卵巢功能并发症
uterine fibroidslaparoscopymodified baseball sutureantral follicle countanti-Müllerian hormonecervical microcirculationovarian functioncomplications
《临床误诊误治》 2026 (18)
62-68,7
江苏省2021年度开放课题立项课题(JSHD2021106)
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