机会性输卵管切除对卵巢功能的影响及临床价值

Effect and clinical value of opportunistic bilateral salpingectomy on ovarian function

目的探讨机会性输卵管切除对卵巢功能的影响及临床价值。方法选取因子宫良性病变行腹腔镜全子宫切除的患者110例,剔除失访病例16例,纳入观察组42例,对照组52例。观察组术中切除输卵管,对照组术中保留双侧输卵管,比较两组患者治疗效果。结果两组的术中出血量、手术时间以及术后住院时间比较,差异无统计学意义(P>0.05)。术后1、3个月,两组患者FSH、LH水平均逐渐升高,E_2、AMH水平均逐渐降低,差异均有统计学意义(P<0.05);术后1、3个月,观察组同期FSH、LH、E_2及AMH水平与对照组相比,差异均无统计学意义(P>0.05)。观察组术后1、3个月围绝经期症状的发生率分别为14.29%、19.05%,对照组术后1、3个月围绝经期症状的发生率为13.46%、17.31%,两组同一时间点围绝经期症状发生率比较,差异无统计学意义(P>0.05)。结论机会性输卵管切除不延长手术时间,不增加术中出血量,不影响术后恢复进度,并可降低术后盆腔包块、卵巢癌的发生率,同时不额外加重卵巢功能的衰退。

Objective To explore the effect and clinical value of opportunistic bilateral salpingectomy on ovarianfunction. Methods A total of 110 patients who underwent laparoscopic total hysterectomy for benign uterine lesions wereselected, 16 lost cases were eliminated. There were 42 cases in the observation group and 52 cases in the control group.The fallopian tubes were excised in the observation group while the bilateral fallopian tubes were retained in the controlgroup. The treatment effects of the two groups were compared. Results There were no significant differences in the amountof intraoperative bleeding, operation time and postoperative hospital stay between the two groups （P〉0.05）. At 1 and3months after operation, the levels of FSH and LH increased gradually, and the levels ofE2 and AMH decreased graduallyin both groups（P〈0.05）; there were no significant differences in the levels of FSH, LH,E2 and AMH between theobservation group and the control group at 1 and3 months after operation （P〉0.05）. The incidences of perimenopausalsymptoms in the observation group at 1 and 3 months after operation were 14.29% and 19.05% respectively; the incidencesof perimenopausal symptoms in the control group at 1 and 3 months after operation were 13.46% and 17.31% respectively;there were no significant differences in the incidence of menopausal symptoms between the two groups at the same timepoint（P〉0.05）. Conclusion Opportunistic bilateral salpingectomy does not increase operation time and intraoperative bloodloss, and does not affect postoperative recovery progress. Conversely, it can reduce the incidences of postoperative pelvicmass and ovarian cancer, without increasing the decline of ovarian function.