绝经前子宫切除与围绝经期综合征的关系探讨

目的为了解育龄妇女子宫切除保留卵巢者围绝经期综合征的情况,进而探讨育龄女性患子宫良性病变时子宫术式的选择及术后补充性激素的重要性。方法选择子宫良性肿瘤子宫切除保留卵巢的患者80例做观察组;同时选取同期正常女性50例做对照组,以问卷形式了解围绝经期综合征症状,以放射免疫法测定患者术后血清FsH,LH,E2,P水平,观察指标还包括性欲、阴道涂片、骨密度,以及心血管疾病发生情况。结果围绝经期综合征出现的频率,观察1组36.84%,观察2组55%,对照组12%,两组分别与对照组比较,差异显著和非常显著(0.05>P<0.01)。术后5年观察1组及观察2组血清FsH,LH水平升高,E2,P水平下降,与对照组比较,均有统计学意义。结论子宫切除术保留卵巢者围绝经期综合征出现早,且症状重。因此,对绝经前子宫良性肿瘤患者应尽量保留子宫、输卵管、卵巢之间血管网的完整性,维持保留卵巢在盆腔中的正常位置,有利于卵巢功能的维持。

Relationship between Hysterectomia before Menopause and Peri-menopause Syndrome

Objective To learn the peri-menopause syndrome of hysterectomia with conservation of ovary and discuss the importance of selection of hysterectomia methods and hormone supplement after operation.Methods 80 cases of hysterectomia with conservation of ovary patient were as observe group and 50 cases of normal adult female were as control group.The clinical syndrome,lab test detection of FsH,LH,E2 and P,sex desire,bone density and cardiovascular situation were observed in both groups.Results The frequency of peri-menopause syndrome was 36.84% in observe group 1,55% in observe group 2control group and 12% in control group.There were significant difference between observe groups(1,2) with that in control group.The female hormone levels after 5 years post-operation were lower than control group.Conclusion The menopause syndromewas earlier and severe for the patient who received hysterectomia with conservative ovary.The uterus should be conserved for benign tumor of uterus as it keeps good anatomic relationship with ovary and peri-structure.