首页|腹腔镜下病灶切除联合子宫动脉阻断术对子宫腺肌病患者NLR、CA125及TGF-β1水平的影响

腹腔镜下病灶切除联合子宫动脉阻断术对子宫腺肌病患者NLR、CA125及TGF-β1水平的影响

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目的:探讨腹腔镜下病灶切除联合子宫动脉阻断术对子宫腺肌病患者中性粒细胞-淋巴细胞比值(NLR)、糖类抗原125(CA125)及转化生长因子1(TGF-β1)水平的影响.方法:收集2020年9月-2023年8月本院的子宫腺肌病患者210例并随机分为对照组(105例,腹腔镜下病灶切除术)和观察组(105例,腹腔镜下病灶切除联合子宫动脉阻断术),比较两组手术时长、术中失血量,术前术后第6个月月经量、疼痛、子宫体积、卵巢功能、NLR、CA125及TGF-β1.结果:观察组术中失血量(276±35ml)、手术时长(87±25min)均低于对照组(357±26ml、115±36 min),术后6个月月经量(12.44±2.14 片/月)、疼痛 VAS 评分(2.06±0.62 分)、子宫体积(89.47±14.25 cm3)、NLR(2.06±0.86)、CA125(20.35±2.71 KU/L)、TGF-β1(35.98±8.12 mg/L)均低于对照组(15.63±1.56片/月、2.45±0.78分、95.36±12.36 cm3、2.45±0.95、24.53±2.48 KU/L、42.63±8.56 mg/L);术后1周,观察组雌二醇水平(159.36±24.71 pg/ml)低于对照组(168.47±27.06 pg/ml),黄体生成素(11.59±3.18 U/L)和卵泡刺激素(27.56±3.84 U/L)高于对照组(10.57±2.87 U/L、26.51±3.49 U/L)(均P<0.05).术后6个月,两组性激素水平无差异,无1例复发.结论:腹腔镜下病灶切除术和腹腔镜下病灶切除联合子宫动脉阻断术均可治疗子宫腺肌病,腹腔镜下病灶切除联合子宫动脉阻断术在提高手术效率、改善痛经症状及降低NLR、CA125及TGF-β1水平,对卵巢功能的影响更优.
Effects of laparoscopic lesion resection combined with uterine artery occlusion for treating patients with adenomyosis on their neutrophil-lymphocyte ratio and their levels carbohydrate antigen 125 and transforming growth factor β1
Objective:To investigate the effects of laparoscopic lesion resection combined with uterine artery occlusion for treating patients with adenomyosis on their neutrophil-lymphocyte ratio(NLR),and their levels of carbohydrate antigen 125(CA125)and transforming growth factor β1(TGF-β1).Methods:210 patients with adenomyosis were col-lected and were randomly divided into control group(105 cases with laparoscopic lesion resection)and observation group(105 cases with laparoscopic lesion resection combined with uterine artery occlusion)from September 2020 to August 2023.The surgical time,the intraoperative blood loss,the menstrual volume before surgery and in 6 months after surgery,the pain status,the uterine volume,the ovarian function,the NLR,and the levels of CA125 and TGF-βi of the patients were compared between the two groups.Results:The intraoperative blood loss(276±35ml)and the operation time(87±25min)of the patients in the observation group were significantly lower than those(357±26ml and 115±36 min)of the patients in the control group.The menstrual volume in 6 months after surgery(12.44±2.14 pads/month),the VAS score(2.06±0.62 points),the uterine volume(89.47±14.25 cm3),the NLR(2.06±0.86),and the levels of CA125(20.35±2.71 KU/L)and TGF-β1(35.98±8.12 mg/L)of the patients in the observation group were significantly lower than those(15.63±1.56 pads/month,2.45±0.78 points,95.36±12.36 cm3,2.45±0.95,24.53±2.48 KU/L and 42.63±8.56 mg/L)of the patients in the control group.In 1 week after surgery,the lev-el of estradiol(159.36±24.71 pg/ml)of the patients in the observation group was significantly lower than that(168.47±27.06 pg/ml)of the patients in the control group.The levels of luteinizing hormone(11.59±3.18 U/L)and follicle stimulating hormone(27.56±3.84 U/L)of the patients in the observation group were significantly higher than those(10.57±2.87 U/L and 26.51±3.49 U/L)of the patients in the control group(all P<0.05).In 6 months after surger-y,there were no significant differences in the sex hormones levels of the patients between the two groups,and there was no any patient with the adenomyosis recurrence.Conclusion:Both laparoscopic lesion resection and laparoscopic le-sion resection combined with uterine artery occlusion can be used to treating adenomyosis of the patients.Laparoscopic lesion resection combined with uterine artery occlusion for treating the patients with adenomyosis has more advantages in the surgical efficiency,the improvement of dysmenorrhea symptoms and reduction of the levels of NLR,CA125 and TGF-β1of the patients,and which has less impact on the ovarian function of the patients.

Adenomyosis of the uterusLaparoscopic lesion resectionUterine artery occlusion surgeryNeutrophil lymphocyte ratioCarbohydrate antigen 125Transforming growth factor β1Surgical indicatorsOvarian functionRecurrence

习一明、许梦丹、刘春红、吕玲

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解放军总医院第一医学中心(北京,100039)

子宫腺肌病 腹腔镜下病灶切除 子宫动脉阻断术 中性粒细胞-淋巴细胞比值 糖类抗原125 转化生长因子1 手术指标 卵巢功能 复发

2024

中国计划生育学杂志
国家人口计生委科学技术研究所

中国计划生育学杂志

CSTPCD
影响因子:1.759
ISSN:1004-8189
年,卷(期):2024.32(7)