子宫肌瘤不同术式对卵巢功能影响的临床研究

Clinical research of different surgical uterine fibroids on ovarian function

目的探讨手术治疗子宫肌瘤不同术式对卵巢功能的影响。方法回顾性分析83例手术治疗的子宫肌瘤患者。按术式分为子宫肌瘤剔除术组(D组)、子宫切除+保留附件组(E组)、全子宫切除术+双侧附件切除术组(F组),比较三组手术前后围绝经期综合征发生率的差异,以及术后E_2、FSH的变化。结果三组术前围绝经期综合征症状发生率差异无统计学意义(P>0.05),术后F组发生率(24.8%)显著高于D、E两组(8.7%,12.9%)(P<0.05),E组发生率高于D组(P<0.05)。D组E_2、FSH术前与术后比较差异均无统计学意义(P>0.05),E、F两组术后2周E_2下降,FSH升高,与术前相比差异均有统计学意义(P<0.05);术后6个月E_2、FSH与术前相比差异均无统计学意义(P>0.05)。结论卵巢和子宫对妇女的内分泌十分重要,子宫肌瘤患者行子宫和卵巢切除应慎重考虑。

Objective To investigate the surgical treatment of uterine fibroids with different surgical procedures on o- varian function. Methods Retrospective analysis of 83 cases of surgical treatment of uterine fibroids patients. Divided accord- ing to surgical myomeetomy group （ D group）, hysterectomy ＋ retained attachment group （ E group）, hysterectomy ＋ bilat- eral oophorectomy group （ F group）, compared three groups before and after surgery in perimenopausaldifferences in the inci- dence of the syndrome, and postoperative E2 , FSH change. Results The preoperative symptoms of menopause the incidence of the syndrome, no significant difference（ P 〉 0. 05 ）, the incidence of postoperative F group （ 24. 8% ） was significantly higher than that of D, E groups （ 8.7 %, 12.9% ） （ P 〈 0. 05 ）, E group was higher than in the D group （ P 〈 0. 05 ）. D group E2, FSH before and after surgery was no significant difference （ P 〉 0. 05 ）, E, F two groups decreased after 2 weeks E2, FSH increased, compared with before surgery were significantly （ P ~： 0. 05 ） ; 6 months after E2 , FSH compared with before surgery no significant difference （P 〉 0. 05 ）. Conclusion Ovarian and uterine endocrine very important for women, uterine fibreids, were treated by removal of the uterus and ovaries sbeuld be earefully cousidered.