腹腔镜筋膜内子宫切除术对卵巢内分泌功能的影响

Effect of laparoscopy classical intrafascial supracervical hysterectomy on ovarian secretion function

目的:探讨腹腔镜筋膜内子宫切除术对女性卵巢功能的影响。方法:选择46岁以下因良性疾病需行单纯子宫切除的非绝经妇女70例分为2组,即腹腔镜筋膜内子宫切除组(CISH组)和传统腹式子宫切除组(AH组)各35例。分别在术前和术后1年、2年测定外周血中FSH、LH、E2、P、T水平,并对术后更年期症状进行随访。结果:术后1年,两组激素水平与术前相比,无明显变化(P>0.05);术后2年,CISH组血清FSH升高、E2下降,与术前相比,差异有显著性(P<0.05),LH较术前轻度升高,差异无显著性(P>0.05)。AH组FSH、LH升高,尤其是FSH升高明显,与术前相比,差异有显著性(P<0.05),而E2明显低于术前(P<0.05),以上指标与CISH组同期比较,差异亦有显著性(P<0.05),AH组术后2年出现更年期症状及雌激素低落的人数明显多于CISH组。结论:CISH术对卵巢功能影响较小,与传统子宫切除术相比较好地保护了卵巢功能。

Objective： To study the effect of laparoscopy classical intrafascial supracervical hysterectomy （CISH） on ovarian function. Methods： 70 no - menopause women under 46 - year - old who suffered from gynaecol benign diseases with hysterectomy signs were divided into CISH and abdominal hysterectomy （AH） with 35 in each group. The levels of blood FSH, LH, E2 , P and T were assessed respectively before operations and 1, 2 years after operations, and the menopause symptoms of the 70 women were observed after operations. Results ： The hormone level of blood showed no significant difference before and 1 year after operations in two groups （ P 〉 0. 05 ） . The levels of blood FSH increased but E2 decreased, and there were significant difference before and 2 years after CISH （ P 〈 0. 05 ） ; In group AH, the levels of FSH, LH increased , especially FSH, and there was obvious difference before and 2 years after operation （ P 〈0. 05）, at the same time the level of E2 decreased obviously; there were obvious difference in the levels of FSH, LH, E2 between CISH group and AH group 2 years after operations （P 〈 0. 05 ） ; the menopause symptom was obvious 2 years after AH. Conclusion： CISH＇s effect on ovarian function was not significant. CISH preserved ovarian function better than AH.