子宫全切术和子宫肌瘤剔除术治疗子宫肌瘤的效果及对卵巢功能的影响比较

目的分析子宫全切术和子宫肌瘤剔除术治疗子宫肌瘤的效果及对卵巢功能的影响。方法选择本院2010年3月～2012年3月收治的120例子宫肌瘤患者，其中60例行子宫全切术的患者为子宫全切组，60例行子宫肌瘤剔除术的患者为肌瘤剔除组，检测两组患者术前、术后卵泡刺激素（FSH）、雌二醇（E2）水平，同时随访1年调查患者围绝经期症状。结果肌瘤剔除组手术时间、术中出血量、肛门排气时间、住院时间均少于子宫全切组（P〈0．05）。术前两组FSH、E2水平无明显差异（P〉0．05），术后肌瘤剔除组FSH及E2水平均低于子宫全切组（P〈0．05），肌瘤剔除组术后FSH及E2与术前无明显差异（P〉0．05）。肌瘤剔除组术后1年内围绝经期症状发生率为15．0％，显著低于子宫全切组（43.3％）（P〈0．01）。结论子宫肌瘤剔除术在减少围绝经期症状发生，保留子宫，维持患者正常卵巢功能等方面具有显著优势。【

The effect of hysterectomy and myomectomy on uterine fibroids and influence on ovarian function

Objective To analyze the treatment efficacy of hysterectomy and myomectomy for uterine fibroids and their effect on ovarian function. Methods 120 cases of patients with uterine fibroids treated in our hospital from March 2010 to March 2012 were selected. 60 cases were given hysterectomy and the other 60 cases were given myomectomy. Preoperative and postoperative follicle stimulating hormone （FSH） and estradiol （E2） level of the two groups were ana- lyzed and the patients were followed up after 1 year to＇examine perimenopausal symptoms. Results Operative time, blood loss, flatus and hospitalization time of myomeetomy group were significantly lower than hysterectomy group （P〈 0.05）. FSH and E2 levels before surgery were not significantly different between the two groups （P〉0.05）. Postoperative FSH and E2 levels in the myomectomy group were significantly lower than that in the hysterectomy group （P〈0.05）. Preoperative and postoperative FSH and E2 levels were not Incidence of perimenopausal symptoms in the myomectomy significantly different in the myomectomy group （P〉0.05）. group in 1 year after operation was 15.0%, and was significantly lower than hysterectomy group （43.3%） （P 〈0.01）. Conclusion Myomectomy is superior to hysterectomy in aspects of reducing incidence rates of perimenopausal symptoms, retaining uterus and maintaining normal ovarian function.