“肌壁大部分切除-子宫重建术”联合曼月乐宫内置入术对卵巢功能的影响

Effects on Ovarian Function by Combining Major Uterine Wall Resection and Reconstruction of the Uterus with LNG-IUS

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)联合曼月乐(LNG-IUS)宫内置入术对卵巢功能的影响。方法按子宫腺肌病的分度方法将子宫腺肌病分为轻、中、重三度,选择其中无生育要求的中、重度患者29例施行"肌壁大部分切除-子宫重建术"+曼月乐宫内置入术(观察组)。另选择同期子宫肌瘤患者28例行子宫肌瘤剔除术(对照组)。分别对两组的术前、术后1个月、3个月及6个月的抗苗勒试管激素(anti-Mullerian hormone,AMH)进行对比观察。结果两组手术均成功,无术中、术后并发症;两组间术前后AMH随时间差异变化对比无统计学意义(P>0.05);观察组术前后AMH随时间差异变化无统计学意义(P>0.05);对照组术前后AMH随时间差异变化无统计学意义(P>0.05)。结论MURU联合LNG-IUS治疗中重度子宫腺肌病短期内对卵巢功能无明显影响,长期效果有待进一步观察。

Objective To observe the effects on ovarian function by combining major uterine wall resection and reconstruction of the uterus（ MURU） with LNG-IUS. Methods According to the criterion of dividing the uterine adenomyosis,this disease includes light,medium and heavy three degrees. Totally 29 cases of moderate and severe levels with no reproductive were selected to treat by combining MURU with LNG-IUS（ as the observation group）. The other 28 cases of hysteromyoma in the corresponding period were implemented by myomectomy（ as control group）. The level of serum anti-mullerian hormone AMH before and after operation one month,three months and six months are observed and compared between two groups respectively. Results All patients were successfully treated in two groups without any intraoperative and postoperative complications. There are not statistical significant differences of AMH in the two groups before and after operation in different periods（ P〉0. 05）. Meanwhile,there was no significant difference of AMH in the observation group and control group intra-group before and after operation（ P〉0. 05）. Conclusions No evident effects on ovarian function are detected in short time by using our clinical method and the long-term impacts remain to be further observed.