子宫切除术中宫颈去留探讨  

A study of conserving or cutting the cervix at hesterectomy

作　　者：吴紫莉[1] 张爱华[2] 陈福光 郑丽[2] 曾琼 

机构地区：[1]暨南大学医学院第三附属医院,珠海市人民医院妇产科,广东珠海519000 [2]暨南大学医学院第三附属医院,珠海市人民医院检验科,广东珠海519000

出　　处：《暨南大学学报（自然科学与医学版）》2000年第4期68-72,共5页Journal of Jinan University(Natural Science & Medicine Edition)

摘　　要：目的 :探讨子宫切除术中宫颈去留的利弊 ,重新评价子宫次全切除术的应用价值。方法 :对 81例子宫次全切和 68例全切除两组病人术后性功能、膀胱功能、更年期症状、血脂及血液流变学情况进行对比 ,并观察残留宫颈情况。结果 :两组术后性功能、膀胱功能均下降 ,以全切组下降更为明显 (P <0 0 1或 0 0 5) ;两组甘油三脂 (TG)、胆固醇 (CHOL)、载脂蛋白B(APOB)、全血粘度及血浆粘度均高于正常对照组 ,载脂蛋白A(APOA)则均低于对照组 (P均 <0 0 1或 0 0 5)。上述各变化及更年期情况两组间相比差异无显著意义。残留宫颈均未发现 1例下垂、息肉或癌瘤 ,涂片均为巴氏Ⅰ或Ⅱ级。结论 :两种术式对卵巢功能早衰的影响是相同的 ,但对性生活与膀胱功能下降的影响全切组更为明显。提倡对每例患者都权衡宫颈去留之利弊 ,并与病人共同决定宫颈的去留 ,以提高手术满意度和术后生活质量。Aim: To study whether is benefit or harm of conserving or cutting the cervix at hesterectomy and evaluate sub-total hesterectomy. Methods:Compared two groups, one is 81 sub-total hesterectomy and the other 68 total hesterectomy for their sexual function、bladder function、 climacteric complaints、 blood lipids and hemorheology and observe the stump cervix. Results: Both groups are poorer in their sexual and bladder function, especially at total hesterctomy. ( P ≤0.01 or 0.05). Both groups are higher in triglycerin、 cholesterin、 apolitoprotein B、 blood viscosity and plasma viscosity; than the normal group Both groups apolitoprotein A had lower than the normal group( P ≤0. 01 or 0. 05). The above changes and climacteric situation are not obvious instructive statisticglly.Ptosis, polyp or cancer,are not found Stump cervixes the cervixes smears are PAPANICOLAOU'S grade Ⅰor Ⅱ. Conclusion: Both operations had the same effect on ovarian function failure, but in total hestereclomy. It is more clear in sexual and bladder function. It is suggested that are should think about the benefit and harm of conserving or cutting the cervix at hesterectomy and inquire the patient's idea obout that. That would improve the satisfaction of operation and living quality. [

关 键 词：宫颈 子宫切除 卵巢功能 子宫次全切除术 

分 类 号：R713.42[医药卫生—妇产科学]