子宫肌瘤不同手术策略对患者卵巢功能和性功能的影响研究

Study on the influence of different surgery strategies to sovarian and the sexual function of the patients with uterine fibroid

目的:对比子宫肌瘤不同手术治疗策略对患者卵巢功能和性功能的影响。方法:选取2008～2011年该院收治的96例子宫肌瘤患者为研究对象,按照入院顺序随机均分为3组各32例,A组患者给予子宫动脉栓塞治疗,B组患者给予子宫全切除术治疗,C组患者给予子宫肌瘤剔除术治疗,分别比较3种方式治疗前后患者卵巢功能和性功能的变化。结果:①A组和C组患者术后3、6个月血清中促性腺激素(FSH)、黄体生成素(LH)水平与术前比较稍有增加(P>0.05);B组患者术后3个月时FSH、LH水平较术前稍升高(P>0.05);术后6个月FSH、LH水平与术前比较明显升高(P<0.05)。术后3月时,B组患者FSH和LH水平高于A组和C组(P>0.05);术后6月时,B组患者FSH和LH水平明显高于A组和C组(P<0.05)。②A组和C组患者术后3、6个月性行为中异常症状评分与术前比较增加,其他指标评分低于术前(P>0.05);B组患者术后3个月时异常症状评分与术前比较增加,其他指标评分低于术前(P>0.05);术后6个月时异常症状评分与术前比较明显增加,其他指标评分明显低于术前(P<0.05)。术后3月时,B组患者性功能低于A组和C术组(P>0.05);术后6月时,B组患者性功能明显低于A组和C组(P<0.05)。结论:子宫动脉栓塞术和子宫肌瘤剔除术对患者卵巢功能及性功能无明显影响,而子宫全切除术使患者卵巢功能及性功能明显受损,对子宫肌瘤患者的治疗应尽可能保留子宫,以提高患者术后生活质量和内分泌稳定。

Objective： To contrast the influence of different surgery strategies to sovarian and the sexual function of the patients with uterine fibroid. Methods： From 2008 to 2011, 96 cases of patients with uterine fibroids were selected as the research object, and were divided into three groups according to the order of in - hospital, the patients of group A （ n = 32） were given uterine artery embolization, of group B （ n = 32） were given total hysterectomy treatment, and of group C （ n = 32 ） were given myomeetomy treatment, then the sovarian and the sexual function of the patients were compared before treatment and 3, 6 months after treatment. Results： （1）At 3, 6 months after treatment, the levels of FSH and LH in group A and C were slightly increased compared with the preoperative （ P 〉 0. 05 ） ; at 3 months after treatment, the levels of FSH and LH in group B were a little increase compared with the preoperative （ P 〉 0.05 ） ; at 6 months after treat- ment, the levels of FSH and LH were significantly increased compared with preoperative （ P 〈 0. 05 ） . At 3 months after treatment, the level of FSH and LH in group B were higher than the group A and C （ P 〉 0.05 ） ; at 6 months after treatment, the levels of FSH and LH in group B were significantly higher than the group A and C （ P 〈 0. 05 ） . （2）At 3, 6 months after treatment, the abnormal symptom in sexual behavior scores in the group A and C were higher than the preoperative, other index score were lower than preoperative （ P 〉 0.05 ） ; at 3 months after treatment, the abnormal symptom in sexual behavior scores in group B were increased compared with the preoperative, other index score were lower than preoperative （ P 〉 0. 05 ） ; at 6 months after treatment, the abnormal symptom in sexual behavior scores in group B were signifi- cantly increased compared with the preoperative, other index score were significantly lower than preoperative （ P 〈 0. 05 ） ; at 3 months after treatment, the sexual function in group B was less than group A and C （ P 〉 0. 05 ） ; At 6 months after treatment, the sexual function of group B was less than group A and C （ P 〈 0.05 ） . Conclusion ： The uterine artery embolization and myomectomy are no obvious influence to the ovarian and sexual function of patients with uterine fibroid, but the total hysterectomy significantly reduce the ovarian and sexual function. We should keep the uterus as far as possible in the treatment of uterine fibroids, in order to improve the quality of life and the postoperative endocrine stability.