腹腔镜及开腹子宫次全切除术对卵巢功能的影响

The Studay of the Effect of Ovarian Function Under Subtotal Abdominal Hysterectomy and Subtotal Laparoscopic Hysterectomy

目的探讨腹腔镜与开腹子宫次全切除术对卵巢功能近远期功能的影响。方法选择因子宫良性病变保留宫颈而行子宫次全切除患者218例,分为两组:腹腔镜组(122例)和开腹组(96例)。所有患者分别于术前、术后1、3、6、12、24个月,采静脉血测定E2、FSH、LH、P、INHB的水平。结果两组同期比较术后3个月内,E2、P、INHB、FSH、LH水平无差异(P>0.05),术后6～24个月开腹组较腹腔镜组E2、P、INHB水平低,FSH、LH水平高,差异有显著性(P<0.05)。结论腹腔镜下子宫次全切术对卵巢功能的影响小于传统开腹手术,在无腹腔镜手术禁忌证情况下,应作为首选术式。

Objective To evaluate the effect of ovarian function after subtotal abdominal hysterectomy and subtotal laparoscopic hysterectomy.Methods 218 patients with benign uterine disease were divided into 2 groups. There were 122 patients performed subtotal laparoscopic hysterectomy,and 96 ones with subtotal abdominal hysterectomy. They were all measured the level of blood E2,FSH,LH,P,INHB preoperation and 1,3,6,12,24 months postoperation.Results There were no differences between the two groups in the level of blood E2,FSH,LH,P,INHB within preoperation and 3 months postoperation （P0.05）. Followed up for 6~24 months,the level of E2,P,INHB was lower and FSH,LH was higher in abdominal group than that of laparoscopic group. Differences were highly significant（P0.05）.Conclusion The effect of ovarian function under subtotal laparoscopic hysterectomy is slight than abdominal way. Subtotal laparoscopic hysterectomy should be the preferred operation under no contraindication compared with subtotal abdominal hysterectomy.