子宫内膜电切术与子宫全切术对近期卵巢功能的影响

Impact of hysteroscopic endometrial electrocision and total hysterectomy on short-term ovarian function.

目的观察子宫内膜电切术及子宫全切术后患者近期卵巢功能变化趋势。方法选择子宫异常出血需行子宫内膜电切术者13例和同期子宫良性病变行子宫全切术者13例为观察对象。两组按年龄、体重指数(w/h)配对,于试验前及手术后1、3、6月进行促卵泡素(FSH)测定,比较试验前后两组FSH水平的变化幅度。结果组内比较:电切组手术后1、3、6月FSH变化差异无显著性意义(P>0.05);全切组手术后1、3月FSH变化差异无显著性意义(P>0.05),手术后6月FSH水平开始升高,差异有显著性意义(P<0.05);组间比较:手术后1、3月FSH变化差异无显著性意义(P>0.05),手术后6月全切组较电切组FSH水平升高,差异有显著性意义(P<0.05)。结论子宫内膜电切术对近期卵巢功能没有影响;子宫全切术即使保留双侧卵巢,术后6个月卵巢功能已有衰退迹象。

Objective To observe the effect of hysteroscopic endometrial electrocision and hysterectomy on the recent ovarian function. Methods Selecting 13 cases who underwent hysteroscopic endometrial electrocision because of abnormal uterine bleeding and the other 13 cases who underwent hysterectomy because of benign diseases. They were matched by age, body mass index. The levels of follicular stimulating hormone （ FSH ） before operation and 1, 3, 6 month after operation were determined to evaluate the ovarian function of two groups. Results The change of FSH level was not significant among 1, 3, 6 month after endometrial eletrocision or hysterectomy （ P〉0.05 ） , but it showed significant difference 6 month after hysterectomy compared with endometrial electrocision group （ P〈0. 05 ）. Conclusion Hysteroscopic endometrial eleetrocision does not compromise ovarian function, but for hysterectomy, even two ovaria reserved, the declined ovarian function has emerged at 6 month postoperatively.