不同术式对子宫肌瘤患者内分泌影响的临床研究

Clinical study on the effects of different surgical uterine fibroids on endocrine

目的探讨不同手术方式对子宫肌瘤患者内分泌功能的影响。方法将107例子宫肌瘤患者根据不同术式分为A组(行子宫肌瘤剥除术)22例、B组(行子宫全切或次全切,保留双附件)67例和C组(行子宫全切,双附件切除)18例。比较各组患者手术前后性激素水平的变化。结果 A组术前,术后8、24周性激素FSH、LH、E2水平差异均无统计学意义(P>0.05);B组术后8周FSH、LH、E2水平与术前比较,差异无统计学意义(P>0.05),术后24周FSH、LH、E2与术前比较,差异有统计学意义(P<0.05);C组术后8周FSH、LH、E2水平与术前比较,差异有统计学意义(P<0.05),术后24周FSH、LH、E2水平与术前比较,差异有统计学意义(P<0.01)。3组术后1年内出现围绝经症状比例分别为9.1%、23.9%、83.3%,差异有统计学意义(P<0.05)。结论不同术式对子宫肌瘤患者内分泌功能的影响不同,临床应根据患者情况谨慎选择合适的手术方式。

Objective To study different surgical methods influence of endocrine function in patients with uterine fibroids. Methods One hundred and seven uterine fibroids patients, according to different operation methods, were divided into observation group A （uterine fibroids cystectomy, n =22）, observation group B （row hysterectomy or subtotal, retain double accessories, n = 67）, and observation group C （line of hysterectomy, bilateral salpingo - oophorectomy, n = 18）. Vari- ability hormone levels before and after operation were compared among the three groups. Results Eight weeks and 24 weeks after the operation, sex hormones FSH, LH, E2 in group A showed no significant difference （P 〉 0.05）. Eight weeks after operation, FSH, LH and E2 of the observation group B showed no statistical difference （P 〉 0.05）, but 24 weeks after operation, they showed significant difference （P 〈 0.05）. In the observation group C, regarding FSH, LH, E2 8 weeks af- ter operation, there was significant difference （P〈 0.05）, and they still showed significant statisti- cal differences 24 weeks after operation （P 〈 0.01 ）. One- year after the operation, the rates of perimenopausal symptoms in three groups were 9.1%, 23.9 %, and 83.3 %, respectively. The dif- ferences were statistically significant （P 〈 0.05）. Conclusion Different surgical endocrine function in patients with uterine fibroids affect clinical surgery differently. Clinically, the right way should be chosen based on patients＇ individual circumstances.