子宫体楔形切除术对卵巢血供的影响

Influence of uterine body wedge resection on ovary blood supply

目的 探讨子宫体楔形切除术对治疗子宫体良性病变卵巢血供的影响.方法 将68例子宫体良性病变患者分为子宫体楔形切除术组（实验组）和传统子宫全切术组（对照组）,比较两组手术前及术后3、6、12个月雌激素、卵巢动脉血流情况,实验组同时检测子宫动脉血流情况.结果 实验组子宫动脉收缩期最大血流速度（Vmax）、舒张末期最小血流速度（Vmin）术后较术前下降,术后3、6、12个月与术前比较,差异有统计学意义（Vmax比较t分别为5.92、5.13、4.18,Vmin比较t分别为8.57、7.35、6.64,均P＜0.05）.对照组卵巢动脉术后收缩期最大血流速度、舒张末期最小血流速度下降,阻力指数升高,雌激素下降较快（对照组术后3、6、12个月与实验组比较：Vmax的t分别为6.48、7.30、8.46,Vmin的t分别为3.73、4.35、5.37,阻力指数的t分别为2.35、2.46、3.13,均P＜0.05;对照组术后6、12个月雌激素水平与实验组比较t分别为2.83、3.73,均P＜0.05）.结论 子宫体楔形切除术不影响卵巢血供,从而维持卵巢的内分泌功能稳定,雌激素水平无明显变化;与传统的子宫全切术比较,其对中青年妇女的身体健康和生活质量有着积极的意义.

Objective To investigate influence of uterine body wedge resection for young patients with uterine benign diseases on ovary blood supply. Methods A total of 68 patients with uterine benign diseases were divided into uterine body wedge resection group （experimental group） and conventional hysterectomy group（ control group）. Serum level of estrogen, ovarian artery blood flow and uterine artery blood flow of these patients in the two groups were examined before operation and at 3, 6 and 12months after operation respectively and compared. Results The Vmax and Vmin of uterine artery blood flow of patients in the experimental group after operation were decreased as compared with those before the operation （for Vma at 3,6,12 months after operation：t = 5.92, 5.13, 4.18 respectively;at 3,6,12 months after operation for Vmin ： t = 8.57, 7.35, 6.64 respectively, all P 〈 0.05 ）. The Vmax and Vmin of ovarian artery blood flow and estrogen level of patients in the control group after operation were decreased sharply, while resistance index （RI） of ovarian artery blood flow was elevated rapidly and estrogen level of the patients in the control group after operationat were decreased sharply （ at 3, 6, 12 months after operation for Vmax： t = 6.48, 7.30, 8.46 respectively; at 3,6,12 months after operation for Vmin ： t ： 3.73, 4.35, 5.37 respectively ; at 3,6,12 months after operation for RI ： t = 2.35, 2.46, 3.13 respectively, all P 〈 0 . 05 ; at 6, 12 moths after operation for serum levels of estrogen ： t = 2.83, 3.73 respectively, both P 〈 0.05 ）. Conclusion It is suggested that uterine body wedge resection doesn＇ t influence on ovarian artery blood supply after operation, which maintains stability of ovarian endocrine functions and less influences on serum level of estrogen after operation. Compared with conventional hysterectomy, uterine body wedge resection is of positive significance for women＇ s health and quality of life.