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目的对宫腔镜子宫内膜电切术后卵巢的功能进行探究。方法收集我院就诊的功血患者66例,随机分为两组:TCRE组33例及子宫次全切除组33例。另同期选择30例月经正常的健康妇女作正常对照。所有患者均在月经干净后3～7天内行宫腔镜子宫内膜电切术,观察术后卵泡刺激素(FSH)、黄体生成素(LH)、雌二醇(E2)、催乳素(PRL)、孕酮(P)、睾酮(T)激素水平比较,并观察彩色阴道多谱勒下卵巢结构及血流动力学变化。结果子宫次全切除组出现FSH值、LH值升高、E2值下降的趋势,与其余两组相比P<0.05,有统计学意义;TCRE组也出现了FSH值、LH值升高、E2值下降,卵巢功能表现出下降趋势,但与正常组比较P>0.05,无统计学意义。卵巢血流参数TCRE组术后十八个月时RI及PI值与正常组相比P<0.05,有统计学意义,而子宫次全切除组术后RI及PI值有上升趋势,与正常组及TCRE组相比P<0.05,有统计学意义。结论 TCRE对卵巢功能的影响不大,在保护绝经前妇女卵巢功能方面优于子宫次全切除术。
Objective To investigate the ovarian function after hysteroscopic endometrial resection. Methods Sixty-six patients with dysfunctional uterine bleeding in our hospital were randomly divided into two groups: 33 cases in TCRE group and 33 cases in sub-total hysterectomy group. Another 30 cases of normal menstruation during normal women as a normal control. All patients underwent hysteroscopic endometrial resection within 3 to 7 days after menstruation was clean. The levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), prolactin (PRL) , Progesterone (P) and testosterone (T), and observe the changes of ovarian structure and hemodynamics under color vaginal Doppler. Results FSH value, LH value increased and E2 value decreased in the subtotal uterine resection group, which showed statistical significance compared with the other two groups (P <0.05). FSH, LH, E2 Value decreased, ovarian function showed a downward trend, but compared with the normal group P> 0.05, no statistical significance. Ovarian blood flow parameters TCRE group 18 months after RI and PI values compared with the normal group P <0.05, statistically significant, and uterine subtotal resection group after RI and PI values are rising, and normal group Compared with TCRE group, P <0.05, with statistical significance. Conclusion TCRE has little effect on ovarian function and is superior to subtotal hysterectomy in protecting ovarian function of premenopausal women.