用Kupperman评分评估围绝经期双侧卵巢切除对围绝经期症状的影响

An Evaluation of the Modified Kupperman Index on Climacteric Symptoms in Perimenopausal Women Underwent Bilateral Ovariectomy

目的:采用改良Kupperman评分系统对围绝经期因妇科良性肿瘤行双侧卵巢切除的患者进行评分,观察双侧卵巢切除对妇女围绝经期症状的影响。方法:2006～2007年在我院因良性疾病行手术治疗同时切除双侧卵巢的围绝经期患者,术后6～12个月发放调查问卷,内容包括患者基本情况和改良Kupperman评分表。询问患者如可以重新选择,是否仍愿意接受双侧卵巢切除手术,根据不同选择将患者分为接受手术组和暂缓手术组,并对Kupperman评分值进行统计学检验。结果:回收有效问卷68份。患者术后Kupperman评分由术前的12.71±9.50增加至20.35±7.84(P=0.000),其中以心悸、性生活质量下降、潮热出汗、疲乏、情绪波动、抑郁多疑等症状的评分增加明显,与术前相比差异有统计学意义(P<0.05)。选择暂缓手术组患者术后情绪波动、头痛及性生活质量下降评分高于接受手术组,差异有统计学意义(P<0.05)。结论:围绝经期双侧卵巢切除后可能会加重妇女的围绝经期症状,进行围绝经期妇科良性疾病手术治疗时,应合理掌握卵巢切除的指征。

Objective： To evaluate the impact of bilateral ovariectomy on climacteric symptoms in perimenopausal women with benign gynecological tumor, as assessed by the modified Kupperman Index. Methods; Perimenopausal women who received bilateral ovariectomy on benign tumor in our department from 2006 to 2007 were recruited. A questionnaire of the modified Kupperman Index （KI） was sent to them postoperative 6 to 12 monks. Patients were further asked to decide whether or not, if it were possible, to accept the bilateral ovariectorny. They were grouped as ＂Accept the surgery＂ and ＂Postpone the surgery＂ according to their answers. Pre- and post-operative KI scores were calculated and subjected to statistical analysis. Results： Sixty-eight efficient questionnaires were returned. Mean KI score was increased from 12.71 ± 9.50 to 20.35±7.84 after the surgery （ P= 0.000）. Postoperative KI scores of heart palpitation, sweating, sexual functioning, fatigue, nervousness, and depression were increased significantly in comparison with pre - operation （ P〈 0.05）. Patients in ＂Postpone the surgery＂ group showed higher scores of nervousness, headache, and sexual functioning compared with those in ＂Accept the surgery＂ group （ P〈 0.05）.Conclusions： Perimenopausal women may at increased risk of experiencing more serious climacteric symptoms after bilateral ovariectomy. Strict indication of ovariectomy should he recommended while performing gynecological operations in perimenopausal women.