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目的探讨采用不同手术方式行子宫全切或次全切而保留一侧或双侧卵巢,术后残留卵巢综合征(ROS)的发生率、发病原因及诊断治疗方法。方法病例选自2002年2月~2006年2月,在我院因良性疾病行子宫全切或次全切,开腹手术531例,腹腔镜手术445例,经阴手术116例,其中发生ROS各为23、9、0例,均有明显症状,经超声证实,一旦确诊选用避孕药等治疗,门诊随访。结果开腹、腹腔镜、阴式手术ROS的发生率分别为4.3%、2.0%、0。腹腔镜手术与开腹手术比较差异有统计学意义(P<0.05),阴式手术缺乏可比性。32例ROS中,18例药物治疗,6例B超穿刺,8例再次手术治疗。结论全子宫或次全子宫切除术保留一侧或双侧卵巢时可发生ROS,而腹腔镜手术可减少ROS发生率,阴式手术可能减少ROS的发生,一旦确诊先用抑制卵巢的药物治疗,无效时可选用B超穿刺和手术治疗,再次手术以腹腔镜首选。
Objective To investigate the incidence of postoperative residual ovary syndrome (ROS) and its causes and diagnosis and treatment in one or both ovaries with or without hysterectomy. Methods From February 2002 to February 2006, 531 cases of laparotomy, 445 cases of laparoscopic surgery and 116 cases of transvaginal surgery were included in this study. Each of 23,9,0 cases, have obvious symptoms, confirmed by ultrasound, once the diagnosis of contraceptives and other treatment options, out-patient follow-up. Results The incidence of ROS in laparoscopic and vaginal surgery was 4.3%, 2.0%, 0 respectively. Laparoscopic surgery and laparotomy had significant differences (P <0.05), lack of comparability of vaginal surgery. In 32 cases of ROS, 18 cases of drug treatment, 6 cases of B-puncture, and 8 cases of reoperation. Conclusions Total hysterectomy or subtotal hysterectomy can retain one or both ovaries when the occurrence of ROS, and laparoscopic surgery can reduce the incidence of ROS, vaginal surgery may reduce the incidence of ROS, once diagnosed with ovarian suppression drug treatment, B-puncture and surgery can be used when invalid, the first choice for laparoscopic surgery again.