绝经后妇女阴式手术前后应用激素替代治疗利弊的探讨

The risk/benefit analysis of hormone replacement treatment in the peritransuaginal operation period in postmenopausal women

目的探讨激素替代治疗(HRT)在绝经后妇女阴式手术前后应用的利弊。方法对绝经后妇女合并有子宫脱垂及不同程度阴道前后壁膨出、张力性尿失禁而实行手术治疗的患者随机分为实验组和对照组,每组25例。实验组在手术前后进行HRT,对照组予安慰剂,观察内分泌各项指标。结果与对照组比较,实验组阴道细胞成熟指数(MI)、致密核指数(KI)、角化指数(CI)明显提高,血清雌二醇(E2)也明显升高,血清卵泡剂激素(FSH)降低,均有显著性差异(P<0.05)。手术时间、术中出血量明显降低,住院天数缩短,有显著性差异(P<0.05)。术后6个月两组B超监测子宫内膜厚度基本一致。结论对绝经后妇女,做阴式手术前后应用HRT并局部用药安全可行,利大于弊。

Objective To observe the clinical effect of HRT treatment before and after trans vaginal operation in postmenopausal women. Methods Two groups of postmenopausal women who suffered form metroptosis,rectocele,cystocele and SUI were divided blindly. HRT was used in the test group, while placebo was used in control group. Endocrinere lated criteria were monitored. Results ① In the test group, significant difference was found in vaginal cells MI ,KI ,CI.The serum E2 level was also greatly improved wihle the FSH level was decreased. ② The operation time,volume of bleeding,the days of hospitalization were also significantly decreased in the test group. ③ The SUI situation was also improved in the test group 3 months later. ④ Almost the same thickness of endometrium was found in two groups six months later.Conclusions It is safe for HRT before and after operation in postmenopausal women who had trans-vaginal operation.