子宫切除术与卵巢功能

目的了解切除子宫,保留双侧或一侧卵巢的妇女术后卵巢功能是否受影响。方法对521名患者进行问卷式回顾性调查,分析术时年龄、手术方式、手术范围、病种与卵巢功能的关系。同时对某一单位1600余名女职工进行正常人群的月经及绝经症状情况调查。结果正常人群组中有197名妇女出现潮热症状,平均年龄(46.87±4.22)岁;手术组患者中出现潮热症状者293名,手术时年龄(42.84±4.37)岁,术后出现潮热的时间是术后(1.99±2.40)年,平均年龄(44.64±4.31)岁,即子宫切除术后卵巢仅有不到2年的正常功能,而且比正常人群还提前两年出现潮热症状(P<0.01)。手术方式及病种与潮热症状的出现无关,手术范围与潮热症状的出现呈正相关(r=0.197,P<0.001)。结论保留卵巢的子宫切除术能影响卵巢功能,使之提前衰退。

Effect of premenopausal hysterectomy on ovarian function

OBJECTIVE: To investigate the influence of premenopausal hysterectomy on the function of the conserved ovaries. METHODS: A retrospective survey was conducted by sending questionnaire to 521 cases of hysterectomized women (with the conservation one or two ovaries) for benign gynecological diseases and 1,600 cases of normal controls (with contact uterus and bilateral ovaries). Age, type of operation, diagnosis and the time of the onset of the menopausal syndrome were asked in the questionnaire. RESULTS: The mean age of the onset of the hot flush (293 cases) in the hysterectomized group was (44.64 +/- 4.31) years, which was significantly lower than that of the normal group (46.87 +/- 4.22) years, 197 cases] (P < 0.01). The mean age of the above 293 women undergoing hysterectomized was (42.84 +/- 4.37) years. The range of the operation was positively correlated with the time of the onset of the menopause syndrome. So there was only (1.99 +/- 2.40)-year interval between the hysterectomy and the onset of the hot flush. CONCLUSION: Hysterectomy with the conservation of bilateral/unilateral ovaries may have some certain influence on ovarian function.