围绝经期妇女子宫良性疾病行子宫切除术同时切除双侧输卵管的临床应用价值探讨  

Evaluation of the clinical value of simultaneous hysterectomy and bilateral salpingectomy in perimenopausal women

作　　者：易清华[1] 凌晟荣[1] 陈克明[1] 何文容[1] 李莉[1] 易村犍[1] 

机构地区：[1]长江大学附属第一医院妇产科,荆州434000

出　　处：《中华妇产科杂志》2012年第2期110-114,共5页Chinese Journal of Obstetrics and Gynecology

摘　　要：目的 探讨子宫良性疾病行子宫全切除术或次全切除术同时切除双侧输卵管对盆腔包裹性积液、卵巢功能及围绝经期症状的影响.方法 选择2000年1月-2006年12月,因子宫良性疾病行子宫全切除术或次全切除术者共1193例,随访至术后48个月,失访334例,完成随访859例.其中同时行双侧输卵管切除术共348例（观察组）,保留双侧输卵管共511例（对照组）.观察两组患者手术后盆腔包裹性积液的发生率、血清性激素水平变化、围绝经期症状的发生情况.结果 （1）盆腔包裹性积液发生率：观察组盆腔包裹性积液的发生率为1.7％ （6/348）,对照组为4.3％ （22/511）,两组比较,差异有统计学意义（P =0.036）.（2）血清性激素水平：术后6～48个月,卵泡刺激素（FSH）、黄体生成素（LH）水平呈升高趋势,雌二醇水平则呈下降趋势.术后3个月时,观察组LH水平为（13.9±2.2） U/L,对照组为（12.6±2.5） U/L,两组比较,差异有统计学意义（P =0.032）；术后6个月时,观察组FSH水平为（17.6±2.2） U/L,对照组为（16.2±2.8） U/L,两组比较,差异有统计学意义（P =0.035）；术后12个月时,观察组FSH水平为（26.7±5.0） U/L,对照组为（24.3±3.1）U/L,两组比较,差异也有统计学意义（P =0.031）,术后12个月时,观察组LH水平为（24.1±3.0）U/L,对照组为（22.5±1.8） U/L,两组比较,差异有统计学意义（P =0.017）；术后24个月时,观察组雌二醇水平为（97±22） pmol/L,对照组为（109±17） pmol/L,差异有统计学意义（P =0.028）；术后48个月时,观察组FSH水平为（34.9±6.7） U/L,对照组为（38.0±4.8） U/L,两组比较,差异也有统计学意义（P =0.043）.其余各时间点两组间各数值比较,差异均无统计学意义（P均＞0.05）.（3）围绝经期症状：术后1、12、48个月时,围绝经期症状的发生率比较,差异均无统计学意义（P＞0.05）,术后6个月时,观察组围绝经期症�Objective To investigate the effects on pelvic pseudocyst,ovarian function and symptoms of peri-menopausal period in patients with benign uterine disease undergoing simultaneous hysterectomy and bilateral salpingectomy.Methods From Jan.2000 to Dec.2006,1193 patients with benign uterine disease underwent total or subtotal hysterectomy,they were followed up for 48 months,334 patients lost follow-up,the other 859 patients were divided into 2 groups,including 348 patients undergoing simultaneous hysterectomy and bilateral salpingectomy in study group and 511 patients undergoing only hysterectomy in control group.The occurrence of pelvic pseudocyst and symptoms of peri-menopausal period and the changes of serum sexual hormone were observed.Results （ 1 ） The rate of pelvic pseudocyst was 1.7% （6/348） in study group,which was significantly lower than 4.3% （22/511） in control group （P =0.036）.（2） There was an increasing trend of follicle-stimulating hormone （FSH） and luteinizing hormone （LH） and a decreasing trend of estradiol （ E2 ） at range of 6 - 48 months after surgery.At 3 months after surgery,LH in study group was significantly higher than that in control group [ （13.9 ±2.2） U/L vs.（12.6 ± 2.5 ） U/L,P =0.032 ]; FSH in study group at 6 months and 12 months after surgery were （ 17.6 ± 2.2） U/L and （26.7 ± 5.0） U/L,which were significantly higher than （ 16.2 ± 2.8 ） U/L and （24.3 ±3.1） U/L in control group （P=0.035 and P =0.031）.At 12 months after surgery,LH in study group of （24.1 ±3.0） U/L was significantly higher than （22.5 ± 1.8） U/L in control group （P =0.017）.E2 in control group of （97 ±22） pmol/L was significantly lower than （ 109 ± 17） pmol/L in control group at 24 months after surgery （ P =0.028） ; FSH in study group was lower than that in control group at 48 months after surgery [ （34.9 ± 6.7 ） U/L vs.（38.0 ± 4.8 ） U/L,P =0.043 ].There were no significant differences of FSH,LH,and E2 between two groups at

关 键 词：子宫切除术 输卵管 妇科外科手术 骨盆 囊肿 

分 类 号：R713.42[医药卫生—妇产科学]