全子宫及双侧输卵管切除对术后卵巢功能的近期影响

发布时间：2019-02-13 14:45

【摘要】：目的在行全子宫切除术的同时,预防性(或机会性)切除双侧输卵管可降低患卵巢/盆腔浆液性癌的风险。文中探讨绝经前女性因子宫良性疾病行腹腔镜下全子宫切除同时预防性切除双侧输卵管对卵巢功能的近期影响。方法回顾性分析广东省人民医院妇科2014年10月至2015年10月期间因子宫良性疾病行腹腔镜下子宫全切除术的60例绝经前女性患者。其中术中同时行双侧输卵管切除术(观察组)与保留双侧输卵管(对照组)患者各30例。比较2组患者术前、术后1个月以及3个月的卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、抗苗勒管激素(AMH)水平变化以及围绝经期症状发生率。结果 2组患者年龄、孕产次、月经周期、手术指征、合并症、既往腹部手术史等临床基线资料差异无统计学意义(P0.05)。观察组与对照组术前、术后1个月以及3个月的AMH分别为(1.08±0.08)和(1.04±0.10)ng/m L、(0.86±0.44)和(0.81±0.48)ng/m L、(0.84±0.94)和(0.68±0.42)ng/m L,差异无统计学意义(F=0.247,P=0.746);与术前AMH水平比较,术后1个月以及3个月均明显下降(P0.05);而术后1个月和3个月的AMH水平差异无统计学意义(P0.05)。2组间FSH、LH及E2水平变化差异无统计学意义(P0.05)。观察组及对照组患者术后1个月、3个月围绝经期症状的发生率分别为6.7%vs 3.3%和10.0%vs 6.7%,差异均无统计学意义(P0.05)。结论绝经前女性因子宫良性疾病行子宫全切除术同时预防性切除双侧输卵管在术后近期内不加重卵巢功能的下降。AMH在评估术后卵巢功能改变上较FSH、LH及E2更为敏感。
[Abstract]:Objective to reduce the risk of ovarian / pelvic serous carcinoma by prophylaxis (or opportunistic) resection of bilateral fallopian tubes at the same time of total hysterectomy. To investigate the recent effects of laparoscopic hysterectomy and prophylactic resection of bilateral fallopian tubes on ovarian function in premenopausal women with benign uterine diseases. Methods 60 premenopausal women who underwent laparoscopic hysterectomy for benign uterine diseases from October 2014 to October 2015 in Guangdong Provincial people's Hospital were retrospectively analyzed. There were 30 cases of bilateral salpingotomy (observation group) and 30 cases of preserving bilateral fallopian tube (control group). The changes of follicle stimulating hormone (FSH),) luteinizing hormone (LH),) estradiol (E _ 2), anti-Muller tube hormone (AMH) levels and the incidence of peri-menopausal symptoms were compared between the two groups. Results there were no significant differences in clinical baseline data such as age, pregnancy and delivery, menstrual cycle, indications of operation, complications and previous abdominal operation history between the two groups (P0.05). The AMH of the observation group and the control group were (1.08 卤0.08) and (1.04 卤0.10) ng/m / L, (0.86 卤0.44) and (0.81 卤0.48) ng/m / L, respectively. (0. 84 卤0. 94) and (0. 68 卤0. 42) ng/m / L, there was no significant difference (F = 0. 247, P < 0. 746). Compared with preoperative AMH, the level of AMH decreased significantly at 1 month and 3 months after operation (P0.05). However, there was no significant difference in AMH level between the two groups at 1 month and 3 months after operation (P0.05). There was no significant difference in FSH,LH and E2 levels between the two groups (P0.05). The incidences of peri-menopausal symptoms in the observation group and the control group were 3.3% and 6.7% respectively at one month and three months after operation (P0.05). Conclusion Total hysterectomy and prophylaxis of bilateral fallopian tubes in premenopausal women with benign uterine diseases do not aggravate the decline of ovarian function in the short term after operation. AMH is more sensitive than FSH,LH and E2 in evaluating the changes of ovarian function after operation.
【作者单位】：南方医科大学研究生学院;广东省人民医院广东省医学科学院妇产科;
【分类号】：R713.42

【相似文献】