保留子宫动脉上行支筋膜内子宫切除术的临床疗效观察

Clinical Study on Intrafascial Hysterectomy Preserving the Ascending Uterine Artery

目的探讨保留子宫动脉上行支筋膜内子宫切除术临床应用价值。方法符合条件的84例患者随机分成保留子宫动脉上行支筋膜内子宫切除术组(研究组)和改良筋膜内子宫切除术组(对照组),观察两组手术各项指标及对卵巢功能、性生活及大小便等情况的影响。结果研究组与对照组之间的手术及术后近期恢复情况各指标无明显统计学差异(P>0.05)。研究组子宫动脉上行支及卵巢支血流检出率为100%。对照组血清FSH、E2与术前相比显著差异(P<0.05),研究组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有显著差异(P<0.05),术后性生活、血糖血脂水平及大小便情况均无明显改变。结论保留子宫动脉上行支筋膜内子宫切除术,术后近期卵巢功能影响小,对大小便、血糖血脂无明显影响,术后子宫动脉上行支及子宫动脉卵巢的血流基本不受影响,其更远期临床效果仍需深入研究。

Objective To investigate the clinical value of preserving the ascending uterine artery in intrafascial hysterectomy. Methods 84 premenopausal women with benign uterine diseases indicated for hysterectomy were included in this study. 41 cases underwent intrafascial hysterectomy with ascending uterine artery （study group） ;43 underwent intrafascial hysterectomy as control. The variables of operation and postoperation were studied and compared, especially the ovarian function and sexual activity. Rseults There were significantly differences in FSH and E2 of the two groups. The results also demonstrated that there was no statistical differences between two groups with regard to the variable of operation and postoperation, urinary, defecate, LH and pulsatility index （PI） of uterine artery. The blood stream screening showed 100% positive in the artery preserved group. Conclusions Intrafascial hysterectomy with preserved uterine artery is favorable as less complications and slight influences on ovarian function , which could improve the quality of life of the patients, the long-term clinical effects should be further followed and studied.