子宫肌瘤不同术式对卵巢功能影响的研究

Studies on different surgical ovarian function of uterine fibroids impact

目的探讨子宫肌瘤采用不同术式对患者卵巢功能的影响。方法淮北市矿工总医院于2009年至2011年接受绝经过渡期子宫肌瘤患者150例,并采用不同的手术方式进行了手术治疗,对患者手术前、手术后3个月和6个月血清中雌二醇(E2)、卵泡刺激素(FSH)和黄体生成素(LH)的表达水平进行分析。结果与手术前以及肌瘤剔除组相比较,全子宫切除组和次全子宫切除组年龄在40～44岁的患者在手术后3个月雌激素水平明显下降,促卵泡生成素水平上升,呈显著性变化(P<0.05)。在手术后6个月,全子宫切除组和次全子宫切除组患者血清中各种激素的水平与手术前和肌瘤剔组相比较没有统计学意义(P>0.05)。与手术前以及肌瘤切除组相比较,全子宫切除组和次全子宫切除组年龄在45～55岁的患者在手术后3个月激素的变化没有显著性(P>0.05)。在手术后6个月,全子宫切除组和次全子宫切除组患者血清中雌激素水平明显下降,促卵泡刺激素明显增加,与手术前和肌瘤剔除组比较具有显著性差异(P<0.05)。结论 45～50岁的绝经过渡期患者实施子宫切除术对卵巢的功能有明显的影响,会使卵巢出现提前衰退。

Objective To explore the different surgical procedures for uterine fibroids in patients with ovarian function.Methods The hospital in 2009—2011 received patients with uterine fibroids menopausal transition 150 cases and the use of different surgical methods for the surgical treatment of patients before surgery,after surgery,3 months and 6 months in serum estrogen hormone,testosterone,follicle-stimulating hormone,luteinizing hormone and pituitary prolactin expression were analyzed.Results Compared with before surgery,and myomectomy group,compared to total hysterectomy subtotal hysterectomy group and the group of patients aged 40~44 years 3 months after surgery significantly decreased levels of estrogen,follicle-stimulating hormone levels rise,showed significant changes（P0.05）.Patients 6 months after surgery,hysterectomy group and subtotal hysterectomy group,serum levels of various hormones before surgery and myomectomy group,compared to no statistically significant（P0.05）.And before surgery,and myomectomy group,compared to total hysterectomy subtotal hysterectomy group and the group of patients aged 45~55 years old in 3 months after surgery,hormonal changes was no significantly different（P0.05）.45~50 years-old patient 6 months after surgery,hysterectomy group and the subtotal hysterectomy group,serum estrogen levels were significantly decreased follicle-stimulating hormone significantly increased,and before surgery and myomectomy group with significant difference（P0.05）.Conclusion 45~50 years-old menopausal transition for patients with hysterectomy on ovarian function has significant impact will occur early ovarian decline.