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目的:探讨不同手术方式对子宫肌瘤患者的内分泌功能及性功能的影响。方法:选取2007年4月～2009年12月在该院行手术治疗的未绝经子宫肌瘤患者114例,根据手术方式的不同分为3组。观察患者术前及术后6个月血清促性腺激素(FSH)、黄体生成素(LH)、雌激素(E2)水平及性功能各项评分的变化。结果:行子宫肌瘤剥除术的患者术后6个月激素水平及性功能各项评分与手术前无统计学差异(P>0.05);行子宫全切术(保留双侧附件)的患者术后6个月FSH、LH水平较手术前明显升高(P<0.05),E2水平、性心理方面评分较手术前明显降低(P<0.05);行子宫全切术(切除双侧附件)的患者术后6个月,FSH、LH水平、性行为中异常症状出现比例的评分较手术前明显升高(P<0.01,P<0.05),E2水平、性欲方面、性心理方面、性高潮方面、射精时间的评分较手术前明显降低(P<0.01,P<0.05)。结论:不同的手术方式对患者的内分泌功能及性功能的影响不同。其中,子宫肌瘤剥除术的影响最轻,行子宫全切术(保留双侧附件)次之,行子宫全切术(切除双侧附件)的影响最为严重。
Objective: To investigate the effects of different surgical methods on endocrine function and sexual function in patients with uterine fibroids. Methods: A total of 114 patients with uterine fibroids who underwent surgery in our hospital from April 2007 to December 2009 were selected and divided into 3 groups according to different surgical methods. The changes of serum gonadotropin (FSH), luteinizing hormone (LH), estrogen (E2) levels and the scores of sexual function were observed before and 6 months after operation. Results: The scores of hormone levels and sexual function at 6 months after operation in patients undergoing hysterectomy were not significantly different from those before operation (P> 0.05). Patients undergoing hysterectomy (with bilateral attachment preserved) The levels of FSH and LH at 6 months after operation were significantly higher than those before operation (P <0.05), and the scores of E2 level and sexual psychology were significantly lower than those before operation (P <0.05). Hysterectomy (bilateral attachment) (P <0.01, P <0.05), E2 level, sexual desire, sexual psychology, orgasm, orgasm in 6 months postoperatively, FSH and LH levels and the proportion of abnormal symptoms in sexual behavior were significantly higher than those before surgery In terms of ejaculation time score was significantly lower than before operation (P <0.01, P <0.05). Conclusion: Different surgical methods have different effects on the endocrine function and sexual function of patients. Among them, the strongest hysteroscopic stripping surgery, hysterectomy hysterectomy (bilateral attachment retained) followed by hysterectomy (removal of bilateral attachment) the most serious impact.