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目的探讨子宫肌瘤采用不同术式对患者卵巢功能的影响。方法淮北市矿工总医院于2009年至2011年接受绝经过渡期子宫肌瘤患者150例,并采用不同的手术方式进行了手术治疗,对患者手术前、手术后3个月和6个月血清中雌二醇(E2)、卵泡刺激素(FSH)和黄体生成素(LH)的表达水平进行分析。结果与手术前以及肌瘤剔除组相比较,全子宫切除组和次全子宫切除组年龄在40～44岁的患者在手术后3个月雌激素水平明显下降,促卵泡生成素水平上升,呈显著性变化(P<0.05)。在手术后6个月,全子宫切除组和次全子宫切除组患者血清中各种激素的水平与手术前和肌瘤剔组相比较没有统计学意义(P>0.05)。与手术前以及肌瘤切除组相比较,全子宫切除组和次全子宫切除组年龄在45～55岁的患者在手术后3个月激素的变化没有显著性(P>0.05)。在手术后6个月,全子宫切除组和次全子宫切除组患者血清中雌激素水平明显下降,促卵泡刺激素明显增加,与手术前和肌瘤剔除组比较具有显著性差异(P<0.05)。结论 45～50岁的绝经过渡期患者实施子宫切除术对卵巢的功能有明显的影响,会使卵巢出现提前衰退。
Objective To investigate the effect of different surgical procedures on uterine fibroids in patients with ovarian function. Methods From 2009 to 2011, the Miner General Hospital of Huaibei City received 150 cases of uterine fibroids in menopause transitional period. Surgical treatment was performed by different surgical methods. Before and after surgery, patients in the serum of 3 months and 6 months after surgery Estradiol (E2), follicle stimulating hormone (FSH) and luteinizing hormone (LH) were analyzed. Results Compared with preoperative and myomectomy group, estrogen levels in all hysterectomy group and sub-hysterectomy group aged 40-44 years were significantly decreased at 3 months after operation, and the level of follicle-stimulating hormone increased Significant changes (P <0.05). At 6 months after surgery, the serum levels of various hormones in patients undergoing hysterectomy and subtotal hysterectomy were not significantly different from those before surgery and myoma (P> 0.05). Compared with preoperative and myomectomy groups, there was no significant difference in hormones at 3 months after operation in all hysterectomies and subtotal hysterectomies between 45 and 55 years of age (P> 0.05). At 6 months after surgery, the levels of estrogen in the serum of patients in the total hysterectomy group and the subtotal hysterectomy group were significantly decreased, and follicle-stimulating hormone was significantly increased, which was significantly different from preoperative and myomectomy group (P <0.05 ). Conclusion 45 ~ 50 years of menopausal patients with hysterectomy have a significant effect on ovarian function, ovarian premature decline will occur.