保留子宫动脉上行支筋膜内子宫切除术式探讨及临床应用的研究

目的:探讨保留子宫动脉上行支筋膜内子宫切除术临床应用价值。方法:符合条件的84例患者,随机分成保留子宫动脉上行支筋膜内子宫切除术组和筋膜内子宫切除术组,观察两组手术各项指标及手术对卵巢功能、性生活及大小便等情况的影响。结果:研究组与对照组之间的手术及术后近期恢复情况,各指标无明显统计学差异(P>0.05),血清FSH、E2对照组术后与术前相比,差异有显著性(P<0.05),研究组术后与术前相比,差异无显著性(P>0.05)。两组更年期症状的发生率差异有显著性(P<0.05)。术后性生活、血糖、血脂水平及大小便情况均无明显改变。研究组术后双侧子宫动脉上行支、子宫动脉卵巢支检出率为100%。结论:保留子宫动脉上行支筋膜内子宫切除术术后近期卵巢功能影响小,性生活质量有所提高,对大小便、血糖、血脂无明显影响,术后子宫动脉上行支及子宫动脉卵巢支的血流基本不受影响,其更远期临床效果仍需深入研究。

Clinical Study on Intrafascial Hysterectomy with Intact Ascending Uterine Artery

Objective:To investigate the clinical value of intrafascial hysterectomy with intact ascending uterine artery.Methods:84 pre-menopausal women with benign uterine diseases who underwent hysterectomy were included in this study.Among them 41 received intrafascial hysterectomy with intact ascending uterine artery(study group);43 underwent intrafascial hysterectomy only as control.The variables of operation and postoperation were studied and compared,especially those about the ovarian function and sexuality.Rseults:There were significant differences in FSH and E_2 level of the two groups.Our results also demonstrated that there were no statistical differences between two groups comparing:the variable of operation and postoperation urinary defecate,LH and pulsatility index(PI) of uterine artery.The Sexual functioning of two groups have been improved,a small part of the operated patients was observed with increased sexual activity.Few patients had symptoms of urinary and defecate.Conclusions:Intrafascial hysterectomy with intact uterine artery could be performed with less complications and slight influences on ovarian function,which could improve the quality of life of the patients.It has less impact on the urine and stool function,plasma glucose and lipid level as well.But still the long-term clinical effects should be followed and studied further.