不同子宫切除术式对子宫肌瘤患者卵巢功能的影响  

Effects of Different Methods for Hysterectomy on Ovarian Function in Patients with Hysteromyoma

作　　者：李洁[1] 韩华[1] 田菲[1] 张媛[1] 牛佳琳 LI Jie;HAN Hua;TIAN Fei;ZHANG Yuan;NIU Jia-lin(Department of Gynecology,Hebei General Hospital,Shijiazhuang 050051,China;Department of Ophthalmology,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院妇科,石家庄050051 [2]河北省人民医院眼科,石家庄050051

出　　处：《临床误诊误治》2022年第3期59-63,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科学研究重点课题计划项目(20170282)。

摘　　要：目的探究不同子宫切除术式对子宫肌瘤患者卵巢功能的影响。方法选取2018年1月—2020年1月收治的98例子宫肌瘤,根据子宫切除术式不同分为对照组和观察组,每组49例。对照组行全子宫切除术治疗,观察组行三角形子宫切除术治疗。比较两组临床相关指标,治疗前后盆底功能障碍问卷简表-20(PFDI-20)评分、女性性功能指数(FSFI)评分及卵巢功能[雌二醇(E_(2))、黄体生成素(LH)、卵泡刺激素(FSH)]变化,观察两组并发症发生情况。结果观察组的手术时间、住院时间均短于对照组,术中出血量少于对照组(P<0.01)。两组术后肛门排气时间比较差异无统计学意义(P>0.05)。治疗后,两组E_(2)水平及PFDI-20总分均较治疗前降低,LH、FSH水平及FSFI总分均较治疗前升高(P<0.05);且观察组治疗后E_(2)水平及FSFI总分高于对照组,LH、FSH水平及PFDI-20总分低于对照组(P<0.05)。观察组并发症总发生率低于对照组(P<0.05)。结论三角形子宫切除术用于子宫肌瘤患者疗效显著,对盆底功能、卵巢功能影响较小,还可提高性生活质量,且术后并发症较少。Objective To explore effects of different methods for hysterectomy on ovarian function in patients with hysteromyoma.Methods A total of 98 patients with hysteromyoma admitted between January 2018 and January 2020 were divided into control group(n=49)and observation group(n=49)according to different methods for hysterectomy.Control group was treated with total hysterectomy,while observation group was treated with triangular hysterectomy.In two groups,clinical related indexes,changes of pelvic floor distress inventory-short form 20(PFDI-20)score,female sexual function index(FSFI)score and ovarian function[estradiol(E 2),luteinizing hormone(LH),follicle stimulating hormone(FSH)]before and after treatment were compared,and incidence rates of complications were observed.Results Compared with those in control group,operative duration and length of stay were significantly shorter,and volume of intraoperative bleeding was less in observation group(P<0.01).There was no significant difference in postoperative anal exhaust time between two groups(P>0.05).After treatment,E 2 levels and the total scores of PFDI-20 were significantly lower,while levels of LH and FSH and the total scores of FSFI were significantly higher than those before treatment in two groups(P<0.05);in observation group,E2 level and the total score of FSFI were significantly higher,while levels of LH and FSH and the total score of PFDI-20 were significantly lower than those in control group(P<0.05).The total incidence rate of complications in observation group was significantly lower than that in control group(P<0.05).Conclusion Triangular hysterectomy is effective in treatment of patients with hysteromyoma,which may achieve little effects on pelvic floor function and ovarian function,improve quality of sexual life and has fewer postoperative complications.

关 键 词：肌瘤 子宫 子宫切除术 三角形子宫切除术 雌二醇 黄体生成素 卵泡刺激素 

分 类 号：R737.33[医药卫生—肿瘤]