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目的观察全子宫切除术保留双侧输卵管与否术前、术后性激素等的变化,以了解全子宫切除术保留双侧输卵管与否对卵巢储备功能的影响。方法选取因子宫良性病变行全子宫切除术(A组)及全子宫+双侧输卵管切除术(B组)患者各40例,采用化学发光分析法分别检测手术前、术后3个月、术后6个月血清卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E_2)、抗苗勒氏管激素(AMH)作为判断卵巢储备功能的指标。结果与术前相比,术后3个月及6个月2组患者FSH、LH水平均明显升高,E_2、AMH水平明显下降,差异均有统计学意义(P<0.05);2组患者术后6个月与术后3个月FSH、LH、E_2及AMH水平比较差异均无统计学意义(P>0.05)。术后3个月及6个月,A组较之B组FSH、LH水平均明显降低,E_2、AMH水平明显升高,差异均有统计学意义(P<0.05)。结论子宫切除后(保留输卵管与不保留输卵管)术后3个月均显示明显降低卵巢储备功能,术后6个月卵巢储备功能下降有所恢复。子宫切除同时切除输卵管比保留输卵管对卵巢的影响更明显。
Objective To observe the changes of preoperative and postoperative hormones during the whole hysterectomy with or without bilateral tubal fallopian tube in order to understand the effect of total hysterectomy on bilateral oviduct reserve or not on ovarian reserve function. Methods Forty patients with benign and malignant uterus underwent hysterectomy (group A) and total hysterectomy (group B), 40 patients were selected by chemiluminescence analysis before operation and 3 months after operation Serum follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E_2) and anti-Müllerian hormone (AMH) were used as indicators of ovarian reserve function after 6 months. Results Compared with that before operation, the levels of FSH and LH were significantly increased and the levels of E_2 and AMH were significantly decreased in both groups at 3 months and 6 months after operation (P <0.05). There were no significant differences between the two groups The levels of FSH, LH, E_2 and AMH at 6 months and 3 months after operation were not significantly different (P> 0.05). After 3 months and 6 months, the levels of FSH and LH in group A were significantly lower than those in group B, and the levels of E_2 and AMH were significantly increased (P <0.05). Conclusions Three months after hysterectomy (with or without tubal retention) showed a significant decrease in ovarian reserve, with a decrease in ovarian reserve 6 months after surgery. Hysterectomy at the same time resection of the fallopian tube oviduct than retain the more obvious impact.