“肌壁大部分切除-子宫重建术”对卵巢功能的影响

Effects of major uterine wall resection and reconstruction of the uterus on ovarian function

目的研究"肌壁大部分切除-子宫重建术"(major uterine wall resection and reconstruction of the uterus,MURU)对卵巢功能的影响。方法根据超声子宫单侧肌壁厚度(前壁、后壁或宫底)或腺肌瘤最大直径分为轻、中、重三度。选取无生育要求的16例中、重度子宫腺肌症患者(观察组)行MURU术,并于术中放置LNG-IUS。另选取同期16例子宫肌瘤患者(对照组)行子宫肌瘤剔除术,观察两组术前、术后不同时段血清AMH值的变化情况。结果两组手术均获成功,无术中及术后并发症;子宫肌瘤组AMH随时间变化差异均无统计学意义(P>0.05)。子宫腺肌症组AMH随时间变化差异亦无统计学意义(P>0.05)。将两组AMH分别在术前、术后1、3、6个月进行对比,差异无统计学意义(P>0.05)。结论 MURU术后近期不影响卵巢功能,但长期影响,有待进一步追踪、观察。

Objective To observe the effects of major uterine wall resection and reconstruction of the uterus （MURU） on ovarian function in patients with adenomyosis. Methods Patients with adenomyosis were divided into three degrees as mild, moderate and severe levels according to the maximum diameter （ MD ） of single - side muscle thickness （front, back and bottom of uterine） or MD of adenomyoma by ultrasound. Sixteen adenomyosis cases with moderate and severe levels were selected and treated with MURU operation as MURU group. Mean- while, sixteen cases with myomectomy were chosen as control group in the corresponding period. The level of se- rum anti - mullerian hormone （AMH） before and after operation in these two groups was measured and ana- lyzed. Results All patients were successfully treated in two groups. No significant difference of AMH was found between the control and MURU groups before and after operation in different time （ P 〉 0.05）. Meanwhile, there was no significant difference of AMH in intra - group of control and MURU groups before and after operation （P 〉 0.05 ）. Conclusion No evident effects of MURU treating adenomyosis on ovarian function are detected in short time. But the long- term impacts remain to be further observation.