改良子宫切除术与子宫次全切除术后对卵巢功能的影响  

Influence of Modified Hysterectomy vs Subtotal Hysterectomy on Ovarian Function after Operation

作　　者：江少如[1] 许少榆[1] 

机构地区：[1]广东揭阳市人民医院,广东揭阳522000

出　　处：《医学临床研究》2012年第7期1325-1326,1329,共3页Journal of Clinical Research

摘　　要：【目的】探讨不同的子宫体切除方式对卵巢功能的影响。【方法】行子宫切除的妇女100例，其中行改良子宫切除术（保留子宫双侧少量浆肌层以达到保留双侧子宫动脉上行支对卵巢的血供）50例为A组，行传统子宫次全切除术50例为B组。观察两组的更年期症状，比较术前、术后1年、2年、3年血清中性激素水平。【结果】术后2年、3年，A组与B组围绝经期综合征发生率相比较差异有显著性（P〈0．01），术后2年、3年血清中卵泡刺激素（FSH）、雌二醇（E2）、孕激素（P）的水平，A组与B组间比较差异有显著性（P〈0．05），A组术前、术后各激素水平比较差异无显著性（P〉0．05），B组血清中FSH、E2、P水平在术后2年、3年及促黄体激素（LH）水平在术后3年与术前比较差异有显著性（P〈0．05）。【结论】子宫动脉上行支对卵巢功能影响较大，保留子宫双侧少量浆肌层的子宫切除术可以避免因子宫切除对卵巢的损害。[Objective] To explore the effects of different uterine resection approaches on ovarian function. [Methods]Totally 100 women with benign uterine disease undergoing hysterectomy in our hospital were selected. Among them, 50 patients underwent modified hysterectomy（retaining a few seromuscular layer of bilateral uterus to reserve the ascending branch of uterine arteries for ovarian blood supply）（group A, n = 50）. Other 50 patients underwent traditional subtotal hysterectomy（group B, n=50）. Climacteric symptoms of two groups were ob- served. Serum levels of sex hormones before, 1, 2 and 3 years after operation were compared. [Results] At 2 and 3 years after operation, there was significant difference in the incidence of perimenopausal syndrome between group A and group B（P〈0.01）. There were significant differences in follicle-stimulating hormone（FSH）, estradiol（E2） and progestin（P） between group A and group B at 2 and 3 years after operation（ P 〈0.05）. There was no signifi- cant difference in serum hormone levels in group A between before and after operation（ P 〉0.05）. There were significant differences in serum levels of FSH, E2 and P in group B at 2 and 3 years after operation and luteinizing hormone（LH） between 3 years after operation and before operation（ P〈0.05）. [Conclusion] The ascending branch of uterine arteries has more impact on ovarian function. Hysterectomy with reserving a few seromuscular layer of bilateral uterus can avoid ovarian damage caused by hysterectomy.

关 键 词：子宫切除术/方法 卵巢 

分 类 号：R713.42[医药卫生—妇产科学]