保留子宫动脉上行支筋膜内子宫切除术对卵巢功能的影响

Influences of Intrafascial Hysterectomy with Intact Ascending Uterine Artery on Ovarian Function

目的探讨保留子宫动脉上行支筋膜内子宫切除术对卵巢功能的影响。方法符合子宫切除条件的84例患者随机分成保留子宫动脉上行支(UAU)的筋膜内子宫切除术组(A组)和改良筋膜内子宫切除术组(B组),观察两组手术前后各项有关指标及手术对卵巢功能、性生活及大小便等情况的影响。结果两组的手术情况及术后近期患者恢复情况各指标无显著性差异(P>0.05),B组血清FSH、E2与术前相比,差异显著(P<0.05),A组血清FSH、E2与术前相比,无统计学差异(P>0.05)。两组更年期症状的发生率差异显著(P<0.05)。术后性生活情况两组相似。A组UAU及卵巢支血流检出率为100%。结论保留UAU筋膜内子宫切除术对术后近期卵巢功能影响小,性生活质量较术前有所提高,术后UAU及子宫动脉卵巢支的血流基本不受影响。其远期效果尚需观察。

[Objective] To investigate the influences on ovarian function of intrafascial hysterectomy with intact ascending uterine artery, [Methods] 84 pre-menopausal women with benign uterine diseases who underwent hysterectomy were included in this study. 41 cases were performed intrafascial hysterectomy with intact ascending uterine artery （A group）; 43 cases underwent intrafascial hysterectomy only as control （B group）. The preoperative and postoperative variables were studied and compared,especially the ovarian function and sexuality , [Rseults] There were significant differences in FSH and E2 of B group compared with those before operation and no statistical differences between two groups in the variable of operation and post-operation, urination, defecation. The sexual functioning of two groups was improved, Few patients had symptoms of urination and defecation, [Conclusions] Intrafascial hysterectomy with intact uterine has less complications and slight influences on ovarian function, It can improve the life of the patients,there is less influence on the blood flow of ascending uterine and the ovarian branch. The long-term clinical effects should be further followed-up and studied.