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目的探讨次全子宫切除术治疗子宫肌瘤对女性卵巢功能的影响。方法 80例接受手术治疗的子宫肌瘤患者,根据手术治疗的方式不同分为观察组和对照组,各40例。对照组患者给予腹腔镜全子宫切除术,观察组给予患者实施次全子宫切除术。观察两组患者手术前及手术后3个月后的雌二醇(E2)水平及促卵泡激素(FSH)含量。结果手术前观察组患者E2水平为(70.65±6.23)mmol/L,对照组为(71.26±6.52)mmol/L,比较差异无统计学意义(t=0.4278,P=0.6688>0.05)。手术后3个月观察组E2水平为(59.34±5.28)mmol/L,对照组为(51.81±5.45)mmol/L;手术后3个月两组的E2水平低于手术前(t=10.6055、14.5788,P=0.0000<0.01),且观察组E2水平明显高于对照组(t=6.2760,P=0.0000<0.01)。手术前观察组FSH含量为(6.49±0.39)U/L,对照组为(6.38±0.42)U/L,比较差异无统计学意义(t=1.2138,P=0.2248>0.05)。手术后3个月观察组FSH含量为(18.33±1.21)U/L,对照组为(13.76±0.85)U/L;手术后3个月两组的FSH含量高于手术前(t=58.9026、49.2301,P=0.0000<0.01),且观察组的FSH含量显著高于对照组,差异有统计学意义(t=15.5462,P=0.0000<0.01)。结论次全子宫切除术治疗子宫肌瘤保留了子宫颈的分泌功能,对患者卵巢功能影响不大,有利于患者的生活质量,具有较高的安全性,如果患者病情允许,此种手术可优先考虑。
Objective To investigate the effect of subtotal hysterectomy on uterine fibroids in women with ovarian function. Methods 80 cases of uterine fibroids undergoing surgical treatment were divided into observation group and control group according to the way of surgical treatment, 40 cases each. Patients in the control group were given laparoscopic hysterectomy, while patients in the observation group were given subtotal hysterectomy. The levels of estradiol (E2) and follicle stimulating hormone (FSH) in both groups before and 3 months after operation were observed. Results The level of E2 in the observation group before operation was (70.65 ± 6.23) mmol / L and that in the control group was (71.26 ± 6.52) mmol / L, the difference was not statistically significant (t = 0.4278, P = 0.6688> 0.05). The level of E2 in the observation group was (59.34 ± 5.28) mmol / L at 3 months after operation and (51.81 ± 5.45) mmol / L in the control group. The level of E2 in the two groups after operation was lower than that before operation (t = 10.6055, 14.5788, P = 0.0000 <0.01). The level of E2 in the observation group was significantly higher than that in the control group (t = 6.2760, P = 0.0000 <0.01). The preoperative FSH content was (6.49 ± 0.39) U / L in the observation group and (6.38 ± 0.42) U / L in the control group, with no significant difference (t = 1.2138, P = 0.2248> 0.05). The level of FSH in the observation group was (18.33 ± 1.21) U / L at 3 months after operation and (13.76 ± 0.85) U / L in the control group. FSH content in the two groups at 3 months after operation was significantly higher than that before operation (t = 58.9026, 49.2301, P = 0.0000 <0.01). The FSH content of the observation group was significantly higher than that of the control group (t = 15.5462, P = 0.0000 <0.01). Conclusion Subtotal hysterectomy for the treatment of uterine fibroids retains the secretory function of the cervix and has little effect on ovarian function in patients, which is good for patients’ quality of life and has higher safety. If the patient’s condition permits, such surgery may be given priority consider.