不同子宫术式对子宫肌瘤患者性激素水平和乳腺增生症的影响

【目的】探讨不同子宫术式对子宫肌瘤患者术后性激素水平和乳腺增生症发生的影响。【方法】选择子宫肌瘤患者168例，根据不同术式分为肌瘤剔除术组（n=52，A组）、次全子宫切除术组（n=57，B组）、全子宫切除术组（n=59，C组）。比较三组患者术后乳腺增生症发生率及术前、术后3个月、术后6个月、术后1年的卵泡生成激素（FSH）、黄体生成激素（LH）、雌二醇（E2）、孕酮（P）、催乳素（PRL）水平。【结果】B组、C组乳腺增生症发生率分别为28．07％和35．09％，均显著高于A组9．62％，差异有统计学意义（P〈0．05）；B组、C组术后3个月、6个月、12个月时FSU、LH水平均显著高于术前和A组，差异有统计学意义（P〈0．05）；B组、C组术后3个月、术后6个月PRL水平均显著高于术前和A组，差异有统计学意义（P〈0.05）；B组、C组E2水平术后3个月、6个月、12个月显著低于术前和A组，差异有统计学意义（P〈0．05）。【结论】全子宫切除术和次全子宫切除术均可使子宫肌瘤患者术后性激素水平发生异常改变，乳腺增生症发生率显著增加，而子宫肌瘤剔除术患者体内性激素水平无明显改变。

Effects of Different uterine Surgery on Sexual Hormone Levels and Mammary Gland Hyperpla-sia in Patients with Uterine Fibroids

Obj ective]To investigate the effect of different uterine surgery on sexual hormone levels and mammary gland hyperplasia in patients with uterine fibroids.[Methods]The 168 cases of uterine fibroids were selected and were divided into two groups (Group A,n=52),subtotal hysterectomy group (n=57,Group B),total hysterectomy group (n=59,Group C)according to the different surgical methods.Mammary gland hyperplasia occurrence rate of three groups of patients were compared together with the levels of follicle stimu-lating hormone (FSH),luteinizing hormone (LH),estradiol (E2 )and progesterone (P)and prolactin (PRL) before operation and 3 months,6 months and 1 year postoperation.[Results]The incidence of mammary gland hyperplasia of Group B and Group C was 28.07% and 35.09% respectively,which were significantly higher than that of 9.62% in Group A,the difference was statistically significant (P <0.05);FSU and LH levels 3 months,6 months,12 months after operation of Group B and Group C were significantly higher than those of Group A,the difference was statistically significant (P <0.05);the PRL level of Group B and Group C 3 months,6 months after operation were significantly higher than those of Group A ,the difference was statisti-cally significant (P <0.05);E2 in Group B and Group C 3 months,6 months,12 months after operation was higher than that of Group A,the difference was statistically significant (P <0.05),[Conclusion]Total hys-terectomy and subtotal hysterectomy may result in abnormal changes of sex hormone levels postoperatively in patients with uterine fibroids,a significant increase in the incidence of mammary gland hyperplasia,and there was no significant change in the level of sex hormones in patients with uterine fibroids.