腹腔镜下次全子宫与全子宫切除、肌瘤剔除术对子宫肌瘤患者卵巢储备功能的影响  

Effects of three surgical modalities on ovarian reserve by assessing the serum level of anti-Mullerian hormone for uterine fibroids

作　　者：袁华[1] 赵绍杰[1] 龚华[1] 梁喜[1] 王沂峰[2] 

机构地区：[1]南京医科大学附属无锡妇幼保健院妇科,214002 [2] 南方医科大学附属珠江医院妇科

出　　处：《中华全科医师杂志》2015年第5期377-380,共4页Chinese Journal of General Practitioners

基　　金：南京医科大学科技发展基金重点项目（2013NJMU202）;无锡市医院管理中心联合攻关项目（YGZXL1301）

摘　　要：对行腹腔镜子宫肌瘤剔除术的33例（剔除组）、腹腔镜次全子宫切除术的31例（次全切组）和腹腔镜全子宫切除术的32例（全切组）,于术前、术后1和4个月行血清抗苗勒管激素（AMH）水平测定.剔除组手术前后血清AMH水平比较差异无统计学意义[（1.42 ±0.65）、（1.31±0.53）和（1.33±0.61） μg/L,P＞0.05];次全切组和全切组术后血清AMH水平均较术前显著下降[（1.17±0.11）、（1.01±0.10）、（0.48 ±0.54）和（1.18 ±0.93）、（0.45-0.39）、（0.14 ±0.00） μg/L,均P＜0.001];全切组术后4个月血清AMH水平下降百分率高于次全切组[（-37.4±37.6）％比（-27.0±23.0）％,P=0.017].提示肌瘤剔除术对卵巢储备无显著影响,全子宫切除术的影响最大.To compare the effects of laparoscopic total or subtotal hysterectomy and myomectomy on ovarian reserve by measuring the serum level of anti-Mullerian hormone （AMH）.A total of 96 patients with uterine fibroids underwent total laparoscopic hysterectomy （TLH group,n =32）,laparoscopic subtotal hysterectomy （LSH group,n =31） and laparoscopic myomectomy （LM group,n =33）.Changes in ovarian reserve were examined by measuring the level of AMH pre-operation and at 1 and 4 months post-operation.No significant differences existed in AMH in LM group[（1.42 ±0.65）,（1.31 ±0.53） ＆amp; （1.33 ±0.61） μg/L,P 〉 0.05].The levels of AMH in both groups were significantly lower than those at pre-operation [（1.17 ± 0.11）,（1.01 ±0.10）,（0.48±0.54） （1.18±0.93）,（0.45 ±0.39）,（0.14±0.0） μg/L,P〈0.001].The mean percentage decrease in AMH was lower in TLH group than that in LSH group at 4-month follow-up [（-37.4 ± 37.6） % vs.（-27.0 ± 23.0） %,P =0.017].The results showed that LM had no effect on ovarian reserve.Both LSH and TLH had adverse effects on ovarian reserve and TLH was more marked.

关 键 词：子宫切除术 腹腔镜 卵巢功能 

分 类 号：R737.33[医药卫生—肿瘤]