开腹手术与腹腔镜下子宫肌瘤剔除术对患者肌瘤复发、氧化应激及血清学创伤指标的影响

Comparative analysis of fibroid recurrence, oxidative stress and serological trauma in patients underwent open surgery and laparoscopic myomectomy

摘要:

目的 探讨开腹手术与腹腔镜下子宫肌瘤剔除术对患者肌瘤复发、氧化应激及血清学创伤指标的影响。方法 选取2018年6月－2019年12月于该院妇产科住院治疗的90例子宫肌瘤患者作为研究对象，按照随机数字表法将患者分为对照组和观察组，每组45例，对照组行开腹手术切除子宫肌瘤，观察组行腹腔镜下子宫肌瘤剔除术。观察两组患者的复发情况、氧化应激和血清学创伤指标。结果 两组患者子宫肌瘤复发率、复发时间和复发时肿瘤直径比较，差异均无统计学意义（P > 0.05）；与术前相比，两组患者术后3和7 d的活性氧（ROS）、丙二醇（MDA）和晚期氧化蛋白产物（AOPP）表达水平较术前明显升高（均P < 0.05）；观察组患者术后3和7 d的ROS、MDA和AOPP表达水平明显较对照组低（均P < 0.05）；对照组患者术后3和7 d的血清缺血修饰白蛋白（IMA）和肌红蛋白（MYO）表达水平均较术前明显升高，总抗氧化能力（TAC）较术前明显降低（均P < 0.05）；观察组患者术后3和7 d的MYO和IMA表达水平明显较对照组低，而TAC明显较对照组高（均P < 0.05）。结论 开腹手术与腹腔镜下子宫肌瘤剔除术后肌瘤复发情况无明显差异，但腹腔镜下子宫肌瘤剔除术可明显减轻机体氧化应激反应和减少组织创伤，对机体不良影响更小。

Abstract:

Objective To investigate the effects of fibroid recurrence, oxidative stress and serological trauma in patients underwent open surgery and laparoscopic myomectomy.Methods 90 patients with uterine fibroids from June 2018 to December 2019 were selected as the study objects. Patients were divided into control group and observation group according to the random number method, with 45 cases in each group. Patients in control group underwent open surgery, and patients in observation group underwent laparoscopic myomectomy. The recurrence rate, oxidative stress and serological trauma were observed in the two groups.Results There was no difference in recurrence rate, recurrence time and tumor diameter between the two groups (P > 0.05). Compared with the preoperative level, ROS, MDA and AOPP expression levels in the two groups on the 3rd and 7th day after surgery were significantly increased (P < 0.05). Compared with the control group, the ROS, MDA and AOPP expression levels of the observation group were significantly decreased on the 3rd and 7th day after surgery (P < 0.05). Compared with the preoperative level, the MYO and IMA expression levels of the two groups were significantly increased at 3 days and 7 days after surgery, while the TAC levels of the two groups were significantly decreased (P < 0.05). Compared with the control group, MYO and IMA expression levels in the observation group were significantly decreased on the 3rd and 7th day after surgery, while TAC levels were significantly increased (P < 0.05).Conclusion There is no significant difference between open surgery and laparoscopic myomectomy in the recurrence of fibroids, and laparoscopic myomectomy can significantly reduce oxidative stress and tissue trauma, with less adverse effects.