目的 探究复杂子宫肌瘤开展腹腔镜全子宫切除术（laparoscopic hysterectomy,TLH）治疗的可行性。方法 选取2017年1月—2019年12月接受手术治疗的76例复杂子宫肌瘤患者,均符合全子宫切除术指征。按照随机数字表法分为两组,对照组38例患者采取开腹全子宫切除术（abdominal hysterectomy,TAH）治疗,研究组38例应用TLH治疗。比较两组患者手术相关指标、术后并发症及卵巢功能水平变化。结果 研究组术中出血量、术后6 h VAS评分低于对照组,术后排气时间、下床活动时间、住院时间短于对照组,（均P<0.05）;研究组术后并发症发生率（5.26%）低于对照组（21.05%）,差异有统计学意义（P<0.05）。两组术前LH、FSH、E2水平比较无统计学差异（P>0.05）,术后3个月两组LH、FSH水平与术前比较均升高,E2水平与术前比较均降低,（均P<0.05）,但组间比较均无统计学差异（P>0.05）。结论 TLH用于复杂子宫肌瘤处理中,术中出血量少,术后疼痛程度低、恢复快,并发症较少,具有重要的应用价值。

Objective To explore the feasibility of total laparoscopic hysterectomy （TLH） in the treatment of complex uterine fibroids. Methods From January 2017 to December 2019, a total of 76 patients with complex uterine fibroids who received surgical treatment were selected. All patients met the indications of total hysterectomy. According to the random number table method, they were divided into two groups： the control group （38 cases） was treated with total abdominal hysterectomy （TAH）, and the study group （38 cases） was treated with TLH. The operation indicators, postoperative complications, and ovarian function were compared between the two groups. Results The study group showed lower intraoperative blood loss and VAS score at 6 h after operation than the control group, and shorter postoperative exhaust time, ambulation time, and hospitalization time （all P<0.05）. The incidence rate of postoperative complications in the study group （5.26%） was lower than that in the control group （21.05%） （P<0.05）. There was no significant difference in the levels of LH, FSH, and E2 between the two groups before operation （P>0.05）; three months after operation, the levels of LH and FSH in the two groups were increased compared with those before operation, while the level of E2 was decreased （P<0.05）, but there was no significant difference between the two groups （P>0.05）. Conclusion TLH in the treatment of complex uterine fibroids features less intraoperative blood loss, lower postoperative pain, faster recovery, and fewer complications, thus has important application value.