不同子宫手术方式对生育期妇女卵巢功能的影响

Effects of different uterine operation methods on ovarian function of women in reproductive period

目的 探讨不同子宫手术方式对生育期妇女卵巢功能的影响.方法 选取2014年2月至2015年7月经确诊为子宫肌瘤并接受子宫手术治疗的120例女性患者,按手术方式不同分为A、B两组,A组55例行子宫肌瘤剔除术,B组65例行子宫切除术.观察手术效果,于术前及术后1、6个月检测卵巢功能指标,并比较术后1年两组卵巢功能和性功能评分.结果 A组手术时间明显长于B组,出血量显著少于B组,术后排气时间明显短于B组,并发症发生率明显低于B组,差异均有统计学意义（P〈0.01）.A组术后1、6个月卵巢功能指标水平与术前比较差异未见统计学意义（P〉0.05）;B组促卵泡生长激素（FSH）、促黄体生长素（LH）均显著升高,雌二醇（E2）水平显著降低（P〈0.05）;且A、B两组比较,术后1、6个月FSH、LH、E2水平比较差异有统计学意义（P〈0.05）.术后1年A组卵巢功能评分略低于B组,但差异未见统计学意义（P〉0.05）,A组性功能评分显著高于B组（P〈0.05）.结论 不同子宫手术方式对生育期妇女卵巢功能的影响不同,子宫肌瘤剔除术手术效果较好,对卵巢功能影响较小,子宫切除术可明显影响患者卵巢功能,降低患者性生活质量.

Objective To investigate the effects of different uterine operation on the ovarian function of women in reproductive period.Methods A total of 120 female patients with confirmed uterine fibroids who received uterine operation from February 2014 to July 2015 were divided into group A and group B.In group A, 55 cases were treated by myomectomy, while 65 cases in group B were treated by hysterectomy.The operation effects were observed.The ovarian function indexes were detected before operation and at 1 month, 6 months after operation.The scores of ovarian function and sexual function were compared between the two groups at 1 year after operation.Results The operation time of group A was significantly longer than that of group B.Compared with group B, the bleeding volume of group A was significantly less, the postoperative exhaust time was significantly shorter, and the incidence of complications was significantly lower （P〈0.01）.At 1 month and 6 months after operation, there was no significant change of ovarian function in group A, compared with that before operation （P〉0.05）.FSH and LH in group B were increased significantly while E2 level decreased significantly （P〈0.01）.There were significant differences in the levels of FSH, LH and E2 between the two groups at 1 month and 6 months after operation （P〈0.05）.At 1 year after operation, the ovarian function score of group A was slightly lower than that of group B （P〉0.05）.The sexual function score of group A was significantly higher than that of group B （P〈0.05）.Conclusions Different uterine operation have different effects on ovarian function of women in reproductive period.The effect of myomectomy is better, and it has little effect on ovarian function while hysterectomy can significantly affect ovarian function and reduce the quality of life of patients.