摘要:
Objective To study the clinical effect of the treatment of benign uterine disease by large partial excision of the uterine with the reservation of the uterine ligament .Methods A total of 94 cases of benign uterine lesions in Anshan Central Hospital from Jan .2013 to Oct.2014 were divided into a trial group and a control group ,47 cases in each group .The trial group received large partial excision of uterine body with the reservation of the uterine ligament ,and the control group received subtotal uterine resection .The operative time , intraoperative blood loss , postoperative exhaust time , ambulation time,postoperative fever ,urinary retention and grade A incision healing of the two groups were compared ;follicle-stimulating hormone (FSH),luteinizing hormone (LH) and estradiol levels of all patients were collected before surgery ,six months after surgery and 1 year after surgery .Results There were no differences in intraoperative blood loss ,operative time ,post-operative exhaust time,ambulation time,the number of cases of postoperative fever and grade A surgical incision healing between the two groups ( P>0.05 ) .The level of FSH in the two groups increased gradually after surgery , but FSH of the trial group was lower than the control group[(5.6 ±1.3) U/L,(5.4 ±1.8) U/L,(6.7 ±2.2) U/L vs (5.4 ±1.8) U/L, (7.3 ±1.9) U/L,(10.3 ±3.2) U/L];the level of serum FSH between groups ,groups· different time points had statisti-cally significant difference ( P0.05).There were no difference in the level of LH between groups ,time points and groups· time points(P>0.05).Estra-diol levels were decreased in both groups after operation ,but the reduction of the trial group was lower than that of the control group[(325 ±15) pg/L,(315 ±19) pg/L,(289 ±12) pg/L vs (327 ±18) pg/L,(224 ±21) pg/L,(232 ±14) pg/L]. There were significant differences between the groups ,between different time points and groups · different time points ( P0.05);随着术后时间的延长两组患者FSH水平逐渐升高,但试验组升高的幅度较对照组小[(5.6±1.3)U/L、(5.4±1.8)U/L、(6.7±2.2)U/L比(5.4±1.8)U/L、(7.3±1.9)U/L、(10.3±3.2)U/L],两组患者血清FSH水平在组间、组间· 时间点交互作用比较,差异有统计学意义(P0.05);LH水平在组间、时间点以及组间· 时间点交互作用比较差异无统计学意义(P>0.05);术后两组患者雌二醇水平均降低,但试验组降低的幅度较小[(325±15)pg/L、(315±19)pg/L、(289±12)pg/L比(327±18)pg/L、(224±21)pg/L、(232±14)pg/L],两组患者在组间、时间点以及组间· 时间点交互作用比较差异有统计学意义(P<0.05).结论 保留子宫韧带血管的子宫体大部切除术治疗子宫良性疾病的效果与子宫体大部切除术相似,不增加不良反应,且对血清FSH以及雌二醇的水平的影响较小.