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目的观察子宫全切术、子宫次全切术和子宫肌瘤剔除术对子宫肌瘤患者内分泌功能的影响。方法选取病理证实为单纯子宫肌瘤的绝经过渡期女性128例,根据术式分为A组(子宫全切术)51例,B组(子宫次全切术)42例,C组(子宫肌瘤剔除术)35例,分别于术前、术后1、3、6、12个月取血,用放免法测卵泡刺激素(FSH)、黄体生成素(LH)和雌二醇(E2),采用重复测量设计方差分析,观察内分泌功能的变化。结果术后A、B、C三组均表现为FSH和LH升高,E2下降,不同测试点上异显著(P<0.01),但以A、B两组变化幅度更大(P<0.01)。测量前后和手术方式存在交互作用,各组FSH、LH和E2的变化趋势不平行(P<0.01)。结论术式对绝经过渡期子宫肌瘤患者内分泌功能影响程度依次是子宫全切术>子宫次全切术>子宫肌瘤剔除术,临床应尽可能选择最大限度切除肿瘤、最小限度保留内分泌功能的术式,以提高术后生活质量。
Objective To observe the effects of hysterectomy, subtotal hysterectomy and myomectomy on endocrine function in patients with uterine fibroids. Methods A total of 128 cases of postmenopausal women with pathologically confirmed uterine fibroids were divided into two groups: group A (total hysterectomy), group B (subtotal hysterectomy), group B (N = 35) were enrolled in this study. Blood samples were collected before operation and at 1, 3, 6, and 12 months after operation. FSH, LH and E2 were determined by radioimmunoassay , Repeated measures design analysis of variance to observe changes in endocrine function. Results The postoperative A, B and C groups showed elevated FSH and LH, decreased E2, and significantly different at different test sites (P <0.01). However, the changes in both groups were greater (P <0.01) . There was interaction between before and after measurement and operation method. The trend of FSH, LH and E2 in each group was not parallel (P <0.01). Conclusions The effect of surgical procedures on the endocrine function of patients with uterine fibroids in the menopause stage is followed by hysterectomy> subtotal hysterectomy> myomectomy. Clinic should choose to maximize tumor excision and minimize endocrine function Surgery to improve postoperative quality of life.