不同手术方式对子宫肌瘤患者性生活质量的影响及发生机制  

Effects and Mechanism of Different Operation Methods on the Sexual Life Quality of Patients with Uterine Fibroid

作　　者：孔令斌[1] 安锐[1] 王邓伟[2] 戚厚兴[3] 张秀平[3] 

机构地区：[1]华中科技大学同济医学院核医学科,湖北省武汉市430030 [2]济宁职业技术学院医院 [3]济宁医学院附属医院妇产科

出　　处：《中国全科医学》2006年第16期1325-1327,共3页Chinese General Practice

摘　　要：目的探讨不同手术方式对子宫肌瘤患者性生活质量的影响及其发生机制。方法将入住济宁医学院附属医院妇产科的120例子宫肌瘤患者随机分为4组,每组30例,分别由同一手术组成员采用不同的手术方式切除子宫肌瘤。对所有患者分别于术前和术后1个月、3个月、6个月时随访,检测雌二醇(E2)、促卵泡激素(FSH)、黄体生成素(LH)的水平,并由统一的调查员遵照盲法原则于患者术前和术后1个月采用统一调查问卷调查患者的性生活质量。结果(1)子宫全切术(TH)组、筋膜内子宫切除(IH)组、子宫次全切除术(STH)组及阴式子宫切除(VH)组各组患者的BISF-W加权评分分别为(167±19)分、(179±37)分、(177±37)分和(181±42)分,分别高于同组术前的加权评分值分别为(164±21)分、(165±41)分、(161±34)分和(165±32)分,差别均有显著性意义(P<0·05);TH组的BISF-W评分明显低于IH组、STH组和VH组(P<0·05),评分值依次为VH组>IH组>STH组>TH组。(2)各组患者术后1个月时激素E2、TSH、LH水平均较手术前明显降低(P<0·05),变化程度依次为VH组<IH组<STH组<TH组。术后3个月时激素恢复到手术前水平。结论不同手术后子宫肌瘤患者的性生活质量不同,其BISF-W评分与患者体内性激素水平变化有关。提示不同手术方式对子宫肌瘤患者性生活质量的影响可能通过对性激素水平的影响而起作用。Objective To explore the effects and mechanism of different surgical operation methods on the sexual life quality of patients with uterine fibroid. Methods 120 uterine fibroid cases, who were in the department of obstetrics and gynecology of Jining Hospital, were randomly divided into four groups, each group had 30 cases, different operation methods were used to cut uterine fibroid by the members of the same operation group. In the follow - up of one month, three months and six months after operation, the levels of estradiol （ E2 ）, follicle stimulating hormone （ FSH）, luteinizing hormone （LH） were detectod, the sexual life quality of the patients was investigated according to the united questionnaire of blind method principle by the united inquirers. Results （ 1 ） The scores of BISF - W in total hysterectomy （TH） group, intrafascial hysterectomy （IH） group, subtotal hysterectomy （STH） group, vaginal hysterectomy （VH） group were （167 ± 19）, （179 ±37）, （177 ±37） and （181 ±42） respectively, which were higher than （164 ±21）, （165 ±41）, （161 ±34） and （165 ±32） in the same group before the operation, there were significant difference （ P 〈 0. 05 ） ; BISF - W scores in TH group were obviously lower than those in IH group, STH group and VH group （ P 〈 0. 05）, which showed VH group 〉 IH group 〉 STH group 〉 TH group. （2） The levels of E2, TSH and LH in one month after operation were obviously lower than those before operation （ P 〈 0. 05 ）, the change degree were VH group 〈 IH group 〈 STH group 〈 TH group. In the third month after operation, hormone level recovered to that before operation. Conclusion The sexual life quality is different in patients with uterine fibroid after different operations, BIST grade is related with the change of sex hormone level, which shows different operation methods affect the sexual life quality of uterine fibroid patients by influencing the sex hormone level.

关 键 词：子宫切除术 手术方式 子宫肌瘤 性激素 性生活质量 

分 类 号：R713.4[医药卫生—妇产科学]