中国妇幼健康研究
中國婦幼健康研究
중국부유건강연구
Chinese Journal of Woman and Child Health Research
2015年
4期
774-776
,共3页
子宫切除术%输卵管%围绝经期%卵巢功能
子宮切除術%輸卵管%圍絕經期%卵巢功能
자궁절제술%수란관%위절경기%란소공능
hysterectomy%fallopian tubes%perimenopausal period%ovarian function
目的 探讨全子宫切除术同时行双侧输卵管切除对卵巢功能的影响. 方法 选取陕西省妇幼保健院及安康市汉滨区第一医院2011年1月至2012年6月因子宫良性病变需实施子宫切除术的患者262例,其中全子宫加双侧输卵管切除术138例为研究组,仅全子宫切除者124例为对照组,记录两组患者手术时间、术中出血量、术后肛门排气时间及术后住院时间. 所有患者于术后1、3、6、12个月门诊随访,详细询问有无围绝经期症状,并行性激素卵泡刺激素( FSH)、黄体生成素( LH)、雌二醇( E2 )的测定. 结果 两组患者手术时间、术中出血量、术后排气时间及术后住院天数比较均无统计学差异( t值分别为-0.460、0.316、0.389、0.167,均P>0.05). 两组术前FSH、LH、E2 水平比较均无统计学差异(t值分别为-0.575、-0.539、-1.967,均P>0.05). 研究组术后1、3、6、12 个月 FSH、LH 均较术前显著升高( t 值分别为 -3.679、 -7.374、18.181、25.133、 -5.688、-13.182、-16.181、-40.089,均P<0.05),对照组术后1、3、6、12月FSH、LH均较术前显著升高(t值分别为-4.479、-12.833、-13.202、-22.363、-5.600、-9.972、-17.369、-34.448,均P<0.05),两组术后1、3、6、12个月E2 均较术前显著下降(t值分别为2.243、3.087、3.679、5.068、1.999、5.169、9.634、11.183,均P<0.05),而两组间术后1、3、6、12个月FSH、LH、E2 水平比较无显著性差异( t值分别为-1.627、-3.945、2.114、3.458、-1.750、0.207、0.528、0.622、-2.911、0.356、3.567、4.913,均 P>0.05). 患者术后各随访时间段均有不同程度的围绝经期症状发生率,但两组比较无统计学差异(χ2 值分别为17.411、163.622、89.321、42.110,均P>0.05). 结论 子宫全切术会影响卵巢储备功能,但术中同时切除双侧输卵管并不加剧这种影响. 故行子宫全切术同时切除外观正常的输卵管,可预防输卵管癌及卵巢癌的发生. 尤其对于有卵巢癌的高危因素或家族史的患者,建议常规切除.
目的 探討全子宮切除術同時行雙側輸卵管切除對卵巢功能的影響. 方法 選取陝西省婦幼保健院及安康市漢濱區第一醫院2011年1月至2012年6月因子宮良性病變需實施子宮切除術的患者262例,其中全子宮加雙側輸卵管切除術138例為研究組,僅全子宮切除者124例為對照組,記錄兩組患者手術時間、術中齣血量、術後肛門排氣時間及術後住院時間. 所有患者于術後1、3、6、12箇月門診隨訪,詳細詢問有無圍絕經期癥狀,併行性激素卵泡刺激素( FSH)、黃體生成素( LH)、雌二醇( E2 )的測定. 結果 兩組患者手術時間、術中齣血量、術後排氣時間及術後住院天數比較均無統計學差異( t值分彆為-0.460、0.316、0.389、0.167,均P>0.05). 兩組術前FSH、LH、E2 水平比較均無統計學差異(t值分彆為-0.575、-0.539、-1.967,均P>0.05). 研究組術後1、3、6、12 箇月 FSH、LH 均較術前顯著升高( t 值分彆為 -3.679、 -7.374、18.181、25.133、 -5.688、-13.182、-16.181、-40.089,均P<0.05),對照組術後1、3、6、12月FSH、LH均較術前顯著升高(t值分彆為-4.479、-12.833、-13.202、-22.363、-5.600、-9.972、-17.369、-34.448,均P<0.05),兩組術後1、3、6、12箇月E2 均較術前顯著下降(t值分彆為2.243、3.087、3.679、5.068、1.999、5.169、9.634、11.183,均P<0.05),而兩組間術後1、3、6、12箇月FSH、LH、E2 水平比較無顯著性差異( t值分彆為-1.627、-3.945、2.114、3.458、-1.750、0.207、0.528、0.622、-2.911、0.356、3.567、4.913,均 P>0.05). 患者術後各隨訪時間段均有不同程度的圍絕經期癥狀髮生率,但兩組比較無統計學差異(χ2 值分彆為17.411、163.622、89.321、42.110,均P>0.05). 結論 子宮全切術會影響卵巢儲備功能,但術中同時切除雙側輸卵管併不加劇這種影響. 故行子宮全切術同時切除外觀正常的輸卵管,可預防輸卵管癌及卵巢癌的髮生. 尤其對于有卵巢癌的高危因素或傢族史的患者,建議常規切除.
목적 탐토전자궁절제술동시행쌍측수란관절제대란소공능적영향. 방법 선취합서성부유보건원급안강시한빈구제일의원2011년1월지2012년6월인자궁량성병변수실시자궁절제술적환자262례,기중전자궁가쌍측수란관절제술138례위연구조,부전자궁절제자124례위대조조,기록량조환자수술시간、술중출혈량、술후항문배기시간급술후주원시간. 소유환자우술후1、3、6、12개월문진수방,상세순문유무위절경기증상,병행성격소란포자격소( FSH)、황체생성소( LH)、자이순( E2 )적측정. 결과 량조환자수술시간、술중출혈량、술후배기시간급술후주원천수비교균무통계학차이( t치분별위-0.460、0.316、0.389、0.167,균P>0.05). 량조술전FSH、LH、E2 수평비교균무통계학차이(t치분별위-0.575、-0.539、-1.967,균P>0.05). 연구조술후1、3、6、12 개월 FSH、LH 균교술전현저승고( t 치분별위 -3.679、 -7.374、18.181、25.133、 -5.688、-13.182、-16.181、-40.089,균P<0.05),대조조술후1、3、6、12월FSH、LH균교술전현저승고(t치분별위-4.479、-12.833、-13.202、-22.363、-5.600、-9.972、-17.369、-34.448,균P<0.05),량조술후1、3、6、12개월E2 균교술전현저하강(t치분별위2.243、3.087、3.679、5.068、1.999、5.169、9.634、11.183,균P<0.05),이량조간술후1、3、6、12개월FSH、LH、E2 수평비교무현저성차이( t치분별위-1.627、-3.945、2.114、3.458、-1.750、0.207、0.528、0.622、-2.911、0.356、3.567、4.913,균 P>0.05). 환자술후각수방시간단균유불동정도적위절경기증상발생솔,단량조비교무통계학차이(χ2 치분별위17.411、163.622、89.321、42.110,균P>0.05). 결론 자궁전절술회영향란소저비공능,단술중동시절제쌍측수란관병불가극저충영향. 고행자궁전절술동시절제외관정상적수란관,가예방수란관암급란소암적발생. 우기대우유란소암적고위인소혹가족사적환자,건의상규절제.
Objective To explore the influence of hysterectomy and bilateral salpingectomy on ovarian function.Methods During January 2011 to June 2012 262 patients needing hysterectomy because of uterine benign disease in Shaanxi Province Maternity and Child Care Hospital and First Hospital of Hanbin District in Ankang City were selected in the study, including 138 cases who underwent hysterectomy and bilateral salpingectomy in study group and 124 cases who underwent hysterectomy alone in control group.Their operation time, intraoperative hemorrhage, postoperative exhaust time and postoperation hospitalization duration were recorded.All patients were followed up after 1, 3, 6 and 12 months, and they were asked whether they had perimenopausal syndrome.Meanwhile their serum sex hormone levels were tested including FSH, LH and E2 .Results There were no statistical differences between two groups in operation time, intraoperative hemorrhage, postoperative exhaust time and postoperation hospitalization duration (t value was -0.460, 0.316, 0.389 and 0.167, respectively, all P>0.05).Preoperative FSH, LH and E2 levels of two groups showed no significant differences(t value was-0.575, -0.539 and -1.967, respectively, all P>0.05).Both FSH and LH levels of the study group rose after 1, 3, 6 and 12 months(t value was -3.679, -7.374, 18.181, 25.133, -5.688, -13.182, -16.181 and -40.089, respectively, all P<0.05), and those of the control group rose too(t value was -4.479, -12.833, -13.202, -22.363,-5.600, -9.972, -17.369 and-34.448, respectively, all P<0.05).But E2 levels of two groups decreased (t value was 2.243, 3.087, 3.679, 5.068, 1.999, 5.169, 9.634 and 11.183, respectively, all P<0.05).There were no statistical significances between two groups in FSH, LH and E2 levels 1, 3, 6 and 12 months after operation ( t value was -1.627, -3.945, 2.114, 3.458, -1.750, 0.207, 0.528, 0.62, -2.911, 0.356, 3.567, 4.913.all P >0.05).Both groups had incidence of perimenopausal symptoms during follow -up periods, but the difference was not significant (χ2 value was 17.411, 163.622, 89.321 and 42.110, respectively, all P >0.05 ) .Conclusion Hysterectomy has influence on ovarian function, but resection of bilateral oviducts at the same time will not aggravate the effect.As a result, hysterectomy plus resection of the oviducts which are normal in appearance can prevent the happening of carcinoma of the fallopian tubes and ovarian tumors.Conventional resection is recommended especially for the patients who have risk factors or family history of ovarian tumors.
