宫腔镜子宫内膜切除术对卵巢动脉血流动力学及卵巢功能的影响

目的　探讨宫腔镜子宫内膜切除术 (TCRE)对卵巢动脉血流动力学及卵巢功能的影响。方法　 35例因异常子宫出血行TCRE的患者 ,分别于术前、术后 1,3及 6月行经阴道彩色多谱勒超声测定卵巢动脉血流阻力指数 (RI)和搏动指数 (PI) ,同时行血清六项性激素检查。结果　术后随访 9～ 18个月 ,无月经 12例 (34.2 9% )、经量减少 19例 (5 4 .2 9% )、复发 4例 (11.4 3% ) ,满意率 88.5 7%。卵巢动脉血流则与PI术后低于术前 ,多无显著性差异 (P >0 .0 5 )。性激素FSH、LH、E2 、P及T手术前与术后 1,3及 6月相比 ,变化无显著性差异 (P>0 .0 5 )。结论　TCRE使卵巢动脉血流阻力降低 ,对卵巢功能无显著性影响。

Influence of transcervical resection of endometrium on ovarian hemodynamics and ovarian function

Objective:To evaluate the influence on ovarian hemodynamics and ovarian function after transcervical resection of endometrium (TCRE) .Methods: The study group was composed of 35 women with AUB undergoing TCRE under hysteroresectoscopy. The patients were examined by transvaginal color doppler (TVCD) and blood specimen preoperatively, and then followed up 1 month, 3 months and 6 months post operatively. With TVCD flow image, to obtain resistance index (RI) and pulsatility index (PI) from ovarian arteries. At same time, to measure the serum follicle stimulating hormone (FSH) , luteinizing hormone (LH) , estradiol (E 2) ,prolactin (PRL), progesterone (P) and testerone (T). Results:Thirty-five patients were followed up after TCRE from 9 months to 18 months. Thirty-one out of 35 women (88.57%) had adequately controlled menorrhagia (34.29% had amenorrhea,54.29% had hypomenorrhea), while 4 women (11.43%) with adenomyosis were failed due to unchanged menstrual flow after surgery. The blood flow impedance of ovarian arteries was all lower at 1 month, 3 months and 6 months after operation. The serum FSH, LH, E2, P, T levels showed no significant difference between preoperation and postoperation. Conclusion: The data suggest that the blood flow impedance of ovarian arteries is lower and ovarian function has no significant change after TCRE.