子宫肌瘤不同术式对卵巢功能影响的临床研究

目的探讨对于绝经过渡期子宫肌瘤患者采用全宫切除、次全宫切除、肌瘤剔除术后卵巢近期功能的影响。方法 312例因子宫肌瘤行不同术式治疗的患者,测定术前、术后3个月、术后6个月的性激素FSH、LH、E2值。结果与术前及肌瘤剔除组相比较,全宫切除、次全宫切除组年龄在40~45岁的患者术后3个月E2明显下降,FSH上升,差异有显著性(P<0.05);术后6个月各种激素水平与术前及肌瘤剔除组相比较差异无显著性(P>0.05)。与术前及肌瘤剔除组相比较,全宫切除、次全宫切除组年龄在46~50岁的患者术后3个月血清中各种激素水平变化无显著性(P>0.05);术后6个月E2明显下降,FSH上升,差异有显著性(P<0.05)。结论子宫切除术对于46~50岁的绝经过渡期患者,近期卵巢的功能受到了明显的影响,对子宫肌瘤患者应慎重选择术式,尽可能保留卵巢血供,维护卵巢功能。

Clinical Studies of Different Surgical Procedures for Uterine Fibroids on Ovarian Function

Objective To investigate the postoperative ovarian recent function for the patients with uterine fibroids in menopausal transition period,undergoing hysterectomy,subtotal hysterectomy and myomectomy.Methods 312 cases of different surgical procedures in patients with uterine fibroids,measuring the levels of sexual hormones FSH,LH and E2 before,three months after and six months after the operations.Results The results of preoperative and myomectomy group compared to hysterectomy,subtotal hysterectomy group,E2 decreased,FSH rised for the age of 40 to 45-year-old patients after 3 months,the difference was significant（P0.05）;but afier 6 months the difference was not significant（P0.05）.The results of preoperative and myomectomy group compared to hysterectomy,subtotal hysterectomy group,there is no significant difference for the age of 46 to 50 years old patients after 3 months（P0.05）;but after 6 months,compared to hysterectomy,subtotal hysterectomy group,the preoperative and myomectomy group had a significant rising in FSH and decreasing in E2（P0.05）.Conclusion hysterectomy for postmenopausal patients with the transitional period of 46 to 50 years old,may impact the recent ovarian function.So it should be careful to choose the surgical patients with uterine fibroids,as much as possible to retain the ovarian blood supply and maintain the ovarian function.