保留子宫血管供应的子宫切除术对卵巢功能影响临床研究

目的探讨保留子宫血管供应的子宫切除术对卵巢内分泌功能及围绝经期症状的影响.方法将子宫良性病变需行子宫切除术的100例患者按门诊编号随机分为保留子宫血管的STHMUV组(研究组,n=50)及传统次全子宫切除SROU术组(对照组,n=50),比较两组手术时间、术中出血、术后发热及残端息肉情况,同时分别于术前、术后3个月,6个月,1 a,2 a抽血化验检查血清中性激素水平变化,并进行围绝经期症状观察.结果两组手术时间、术中出血量、术后发热及残端息肉比较无统计学意义(P0.05).研究组手术前后血清性激素变化比较差异无统计学意义(P0.05),围绝经期症状几乎不出现;对照组术后FSH,LH明显升高(P0.05),E2降低(P0.05),围绝经期症状出现较多.结论 STHMUV术组在卵巢激素分泌方面的影响不如传统SROU术组明显,该术式对保留卵巢功能、延缓卵巢早衰的出现具有一定的临床意义.

Clinical Research on the Effect of Uterine Blood Supply Retained Hysterectomy on Ovarian Function

Objective To explore the effects of uterine blood supply retained hysterectomy ( STHMUV ) on the endocrine function of ovarian and the symptoms of menopausal transition. Method According to the outpatient number,100 patients with uterine benign lesions needed SROU were randomly divided into the STHMUV group ( research group,n=50 ) and the traditional total hysterectomy group ( the control group, n=50 ) . The operation time,intraoperative bleeding, postoperative fever and residual polyp were compared between the two groups. Simultaneously,the changes of serum sex hormone levels and the perimenopausal symptoms were determined and observed at 3 m,6 m,1 a,2 a before and after the operation. Results There was no significant difference between the two groups in operation time,intraoperative blood loss,postoperative fever and residual polyp (P>0. 05). There was no significant difference in serum sex hormones of the research group before and after the operation (P>0. 05),and the symptoms of the menopausal transition hardly appeared. While in the control group, postoperative FSH,LH increased significantly(P<0. 05),E2 decreased(P<0. 05),and perimenopausal symptoms appeared frequently. Conclusion The effect of STHMUV on ovarian endocrine function was less than the traditional total hysterectomy. This operation has clinical significance for preserve ovarian function and delay the occurrence of premature ovarian failure.