全子宫切除术对卵巢血流及内分泌功能的影响

Influence of total hysterectomy on endocrine function and ovarian blood flow of the women

全子宫切除术是妇科最常见的手术,传统手术方式无论通过何种途径,均需切断子宫动脉及其卵巢支,破坏了残留卵巢的血供,从而对患者术后的内分泌功能造成一定程度的影响。该文综述了全子宫切除术对患者术后的性激素水平及心、脑、血管、骨骼等方面的影响,以及通过多普勒超声对因良性疾病行全子宫切除术患者的卵巢动脉搏动指数、抵抗指数、收缩期与舒张期比值及卵巢间质血流,包括血管指数、血流指数及卵巢动脉收缩期峰值速度的测定,观察患者手术前后卵巢局部血流的变化,并在改进手术方式和严格手术指征方面对减少以上影响进行讨论。

Total hysterectomy is the most common operation in department of gynecology. The uterine arteries and their ovarian branches would be cut in any traditional mode of operation, which decreases blood supply of the residual ovary. Thus the operation would affect endocrine function of the patients at certain extent. In this article, we reviewed influence of total hysterectomy on patients＇ sexual hormone levels and heart, brain, vessels and bones, and observed changes in pulsatility index（PI） , resistance index （RI）, systole/diastole ratio （S/D） of ovary artery and ovarian interstitial blood flow including vascularization index （VI） , flow index（ FI）, vaseularization blood flow index（VFI） and systolic peak velocity （SPV） of ovary artery of the patients who underwent total hysterectomy due to benign diseases detected by Doppler ultrasonography. Moreover, we discussed measures to decrease such influences through improving procedures of operation and strictly grasping operation indications.