手术治疗功能失调性子宫出血对卵巢功能的影响
| 作者: |
1李飞燕,
1杨立,
1任琛琛,
1白杨,
1任瑞芳,
1赵娜,
1薛景戈,
1李玛俊
1 郑州大学第三附属医院妇产科学，郑州 450052 |
| 通讯: |
任琛琛
Email: renchenchen1106@126.com |
| DOI: | 10.3978/j.issn.2095-6959.2014.06.020 |
摘要
目的：了解不同手术方式治疗功能失调性子宫出血对女性卵巢功能的影响。方法：选择2013年1月 至2014年1月在郑州大学第三附属医院因功能失调性子宫出血(dysfunctional uterine bleeding，DUB) 行手术治疗患者，所有完成随访的患者按手术方式分为三组，即宫腔镜子宫内膜电切术组、腹腔 镜下单纯子宫全切术组及腹腔镜下子宫全切+双侧输卵管切除组，观察其术前及术后1、3、6个月 激素水平的变化以了解对卵巢功能的影响。结果：三组试验组术前5项激素水平比较P>0.05，差异 均无统计学意义；宫腔镜子宫内膜切除术后5项激素水平均无明显变化，与术前比较P>0.05，差异 无统计学意义；子宫全切术(包括保留输卵管和切除术输卵管)后FSH、LH均升高，E2、P水平均下 降，T无明显变化，术后1个月与术前比较P>0.05，差异无统计学意义，术后3、6个月与术前比较 P<0.05，差异均有统计学意义。子宫全切(包括保留输卵管和切除术输卵管)术后1、3、6个月两组 之间5项激素比较P>0.05，均无显著性差异；分别与宫腔镜组比较术后1个月P>0.05，差异无统计 学意义，术后3、6个月FSH、LH、E2、P值P<0.05，差异均有统计学意义，T值P>0.05，差异无统 计学意义。结论：不同手术方式治疗功能失调性子宫出血对卵巢功能的影响不同，子宫全切术可 引起绝经前妇女卵巢功能下降，同时切除输卵管并不会加重子宫全切术对绝经前妇女卵巢功能的 影响，而宫腔镜下子宫内膜电切术对卵巢功能无明显影响。
关键词：
功能失调性子宫出血
子宫内膜电切术
子宫全切术
输卵管
卵巢功能
The effects of surgical treatments of dysfunctional uterine bleeding on ovarian function
CorrespondingAuthor: REN Chenchen Email: renchenchen1106@126.com
DOI: 10.3978/j.issn.2095-6959.2014.06.020
Abstract
Objectives: To investigate the effects of different surgical interventions in the treatment of dysfunctional uterine bleeding on women’s ovarian function. Methods: We selected dysfunctional uterine bleeding patients whom underwent the surgical treatments in the Third Affiliated Hospital of Zhengzhou University from January 2013 to January 2014. All the patients completed the follow-up were divided into three groups according to the ways of surgery, i.e. transcervical resection of endometrium (TCRE group), the simple laparoscopic hysterectomy group and the laparoscopic hysterectomy + bilateral tubal resection group. The changes of preoperative and postoperative hormone levels at 1, 3, 6 months were all observed in order to learn about the influences on ovarian function. Results: The P value of five hormone levels in three intervention groups before the surgery was more than 0.05, the difference has no statistical significance. The five hormone levels of the TCRE group were no changed and when compared with the preoperative, there still has no significant difference. After hysterectomy (including retain oviduct and resection of oviduct), the FSH and LH levels were all increased, while the E2 and P levels were decreased, T levels had no obvious changes, there was no significant difference between the preoperative and postoperative 1 months. But at 3 and 6 months, there was a significant difference compared with the preoperative P<0.05. Comparison of 5 hormone levels in the Hysterectomy (including retain oviduct and resection of oviduct) group at 1, 3, 6 months in between groups, there were all no significant difference. Compared with the TCRE group, the difference has no statistical significance after surgery 1 month, while the P values of FSH, LH, E2 at 3, 6 months after surgery were all more than 0.05. However, the P value of T levels was more than 0.05 and means there was no significant difference. Conclusion: Different surgical interventions in the treatment of dysfunctional uterine bleeding may have different effects on ovarian function. The hysterectomy may cause ovarian function decline in premenopausal women and simultaneous resection of oviduct does not increase the influence of ovarian function in premenopausal women, the same effects can also be seen in the transcervical resection of endometrium group.