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目的探讨子宫全切术和子宫肌瘤剔除术对子宫肌瘤患者卵巢功能的影响。方法 选择妇产科确诊的子宫肌瘤患者138例,69例行子宫全切术(全切组),69例行子宫肌瘤剔除术(剔除组),于术前及术后1、3、6个月测量卵泡刺激素(FSH)、黄体生成素(LH)和雌二醇(E2),随访1年了解围绝经期症状。结果 (1)全切组术后FSH、LH水平高于术前,E2水平低于术前(P<0.05或P<0.01),而剔除组仅6个月时的LH水平高于术前;全切组术后3、6个月时的FSH、LH水平高于剔除组,1、3、6个月时的E2水平低于剔除组(P<0.05或P<0.01)。(2)剔除组1、3、6个月时月经完全恢复正常率分别是4.35%、33.33%和91.3%。全切组和剔除组术后1年内围绝经期症状发生率分别为39.13%、10.15%(χ2=16.305,P=0.000)。结论子宫肌瘤剔除术具有保留子宫、减少围绝经期症状、维持女性正常卵巢功能等优点,是治疗子宫肌瘤的理想术式。
Objective To investigate the effect of hysterectomy and myomectomy on ovarian function in patients with uterine fibroids. Methods 138 cases of uterine fibroids diagnosed by obstetrics and gynecology were selected, 69 cases underwent hysterectomy (complete resection group) and 69 cases underwent myomectomy (excluding group) FSH, LH and estradiol (E2) were measured at 6 months, and were followed up for 1 year to understand the symptoms of perimenopausal period. Results (1) The levels of FSH and LH in the resection group were significantly higher than those in the preoperation group, and the levels of E2 in the resection group were lower than those in the preoperative group (P <0.05 or P <0.01) The levels of FSH and LH in the resection group were higher than those in the rejection group at 3 and 6 months after operation, and those in the 1,3,6 months were lower than those in the rejection group (P <0.05 or P <0.01). (2) The normal recovery rates of menstruation at 1, 3 and 6 months after culling were 4.35%, 33.33% and 91.3% respectively. The rates of perimenopausal symptoms in the resection group and the excision group were 39.13% and 10.15% respectively (χ2 = 16.305, P = 0.000) within 1 year after operation. Conclusion Uterine myomectomy has the advantages of retaining the uterus, reducing perimenopausal symptoms and maintaining normal ovarian function in women. It is an ideal surgical method for the treatment of uterine fibroids.