单纯子宫切除对卵巢功能的近远期影响

目的 :探讨子宫切除后卵巢功能减退情况 ,对慎重切除子宫提供依据。方法 :选择 6 0例单纯子宫切除的患者 ,按术后随访年限随机分 3组。术后 1年为 组 ,术后 1～ 3年为 组 ,术后 3年以上为 组。每组各 2 0例 ,均于术前月经第 3天检测 1次 6项生殖激素作为术前激素水平基础值 ,与术后 1年内、 1～ 3年、 3年以上检测 6项生殖激素水平进行对比。结果 :术后1年内 FSH、L H水平升高 ,E2 、P、T有不同程度下降 ,与术前激素水平值比较 ,均有显著差异 ( P<0 .0 5 )。术后 1～ 3年内 ,FSH、L H水平明显升高 ,E2 水平明显下降 ,与术前激素水平值比较 ,均有显著差异 ( P<0 .0 1)。术后 3年以上 ,FSH、L H水平升高更加明显 ,E2 水平下降急剧 ,明显低于术前激素水平值 ,差异有非常显著意义 ( P<0 .0 0 1)。结论 :子宫切除术影响卵巢血运 ,致卵巢功能逐渐衰退 ,提前进入更年期 ,所以对子宫切除应持慎重态度

Short and long term influence of simple hysterectomy on ovarian function

Objective:To discuss the decrease of ovarian function after simple hysterectomy, provide the proof about surgical removal of the uterus cautiously.Methods:Sixty patients received simple hysterectomy were divided into 3 groups according to years of follow-up: patients followed up within 1 year were assigned into I group, 1～3 years into II group, and more than 3 years into III group. There were 20 patients in each group. Before operation, sexual hormones of serum obtained at the third day after menstruation were detected as the base level, compared with that within 1, at 1～3, and more than 3 years.Results:FSH, LH level was increased, and E2 level decreased within 1 year after operation, compared with that before operation, and the difference was significantly ( P <0.05). FSH, LH level was increased significantly, and E2 level highly decreased at 1～3 years after operation, compared with that before operation, and the difference was significantly ( P <0.01). Three years after operation, FSH, LH level was increased more obviously, E2 level decreased sharply, and the difference was significantly ( P <0.001) compared with that before operation.Conclusion:The blood supply of ovary is affected after hysterectomy, resulted in the decline of ovarian function gradually, and entering into climacterium in advance. So decision of surgical removal of the uterus should be determined cautiously.